Quality of life, family burden and psychiatric disorders of relatives of patients with obsessive compulsive disorder

Bu çalışmada obsesif kompulsif bozukluklu hasta ve kontrol yakınlarında yaşam kalitesi, aile yükü ve psikiyatrik bozuklukların değerlendirilmesi amaçlanmıştır.Çalışmaya 40 OKB hastası ile 47 birinci derece yakını ve 40 sağlıklı kontrol ile bunların 45 yakını alındı. Obsesif kompulsif semptomların tipi ve şiddetini saptamak için saptamak Yale-Brown Obsesyon Kompulsiyon Ölçeği (YBOKÖ) ve yeti yitimi değerlendirme ölçeği kullanıldı. OKB ve diğer anksiyete bozuklukları veya duygudurum bozuklukları tanılarını değerlendirmek için SCID-I/CV (Structured Clinical Interview for DSM-IV / Clinical Version), komorbid eksen II kişilik bozukluklarının saptanmasında SCID-II (Structured Clinical Interview for DSM-III-R Personality Disorders) kullanıldı. Hasta yakınlarında aile yükü Zarit bakımveren yükü ölçeği (ZBYÖ), yaşam kalitesi ise Dünya Sağlık Örgütü (DSÖ) Yasam Kalitesi Ölçeği Kısa Formu Türkçe Versiyonu (WHOQOL-BREF TR ) kullanılarak değerlendirildi.OKB'li hasta yakınlarında ZBYÖ ortalama puanı, kontrol yakınlarına göre anlamlı olarak yüksekti. Lineer regresyon analizi ile hastada major depresyonun bulunması, hastalık süresi ve zayıf içgörü ZBYÖ için bağımsız etkenler olarak bulundu. Yaşam kalitesi alan puanları hasta yakınlarında kontrol yakınlarına göre anlamlı olarak düşük olduğu görüldü. Hasta yakınlarında major depresyon kontrol yakınlarına göre anlamlı olarak yüksek olduğu bulundu. Hasta ve kontrol yakınları arasında anksiyete bozuklukları açısından herhangi bir fark bulunmadı.Çalışamız OKB'nin sadece hastaları değil aynı zamanda hasta yakınlarını da etkileyen bir hastalık olduğunu göstermektedir. Buna göre hasta yakınlarının da tedaviye dahil olması onların aile yükünü azaltabilir ve bozulmuş yaşam kalitelerinin belli ölçüde düzelmesini sağlayabilir.The aim of this study is to assess the quality of life (Qol), family burden and psychiatric disorders in first degree relatives of patients with OCD and to compare them with healty controls and their relatives.Fourty patients with OCD and fourty seven their first degree relatives, fourty healty person and their fourty first degree relatives were recruited in this study. Type and severity of obsessive-conpulsive symtoms were assessed with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and Disability Assessment Schedule (WHO DAS II). OCD and other anxiety or mood disorders were determined by means of the Structured Clinical Interview for DSM-IV (SCID-I). Comorbid axis II disorders were diagnosed with the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). Family burden and Qol were evaluated by Zarit Burden Interview and WHQOOL-BREEF in relatives.The mean ZBI score of family members of OCD patients were higher than control relatives.The lineer regression analysis indicated that the independent factors associated with ZBI were duration of illness, comorbid major depressive disorder and poor insight. Compared with that of control relatives, the Qol of relatives of patients with OCD was significantly lower in all domains. While the diagnosis of major depressive disorder at relatives of OCD patients was explored significantly higher than control relatives, the diagnosis of any anxiety disorder did not differ.Our study provides evidence that OCD not only affects the lives of patients, but also their family members. Thus, this findings suggest that involving family members in the treatment of OCD could improve their perceived Qol and decrease their burden

Resiliency-Sensitive Decision Making Mechanism for a Residential Community Enhanced with Bi-Directional Operation of Fuel Cell Electric Vehicles

The trend regarding providing more distributed solutions compared to a fully centralized operation has increased the research activities conducted on the improvement of active regional communities in the power system operation in the last decades. In this study, an energy management-oriented decision-making mechanism for residential end-users based local community is proposed in a mixed-integer linear programming context. The proposed concept normally includes inflexible resiliency-sensitive load–demand activated as flexible during abnormal operating conditions, fuel cell electric vehicles (FCEVs) fed via the hydrogen provided by an electrolyzer unit connected to the residential community and capable of acting in vehicle-to-grid (V2G) mode, common energy storage and photovoltaic (PV) based distributed generation units and dispersed PV based generating options at the end-user premises. The combination of the hydrogen–electricity chain with the V2G capability of FCEVs and the resiliency-sensitive loads together with common ESS and generation units provides the novelty the study brings to the existing literature. The concept was tested under different case studies also with different objective functions

Resiliency-Sensitive Decision Making Mechanism for a Residential Community Enhanced with Bi-Directional Operation of Fuel Cell Electric Vehicles

The trend regarding providing more distributed solutions compared to a fully centralized operation has increased the research activities conducted on the improvement of active regional communities in the power system operation in the last decades. In this study, an energy management-oriented decision-making mechanism for residential end-users based local community is proposed in a mixed-integer linear programming context. The proposed concept normally includes inflexible resiliency-sensitive load–demand activated as flexible during abnormal operating conditions, fuel cell electric vehicles (FCEVs) fed via the hydrogen provided by an electrolyzer unit connected to the residential community and capable of acting in vehicle-to-grid (V2G) mode, common energy storage and photovoltaic (PV) based distributed generation units and dispersed PV based generating options at the end-user premises. The combination of the hydrogen–electricity chain with the V2G capability of FCEVs and the resiliency-sensitive loads together with common ESS and generation units provides the novelty the study brings to the existing literature. The concept was tested under different case studies also with different objective functions

Doğum şeklinin doğum sonrası depresyon, algılanan sosyal destek ve maternal bağlanma ile ilişkisi

Amaç: Yazında doğum şeklinin, doğum sonrası depresyon ve anne-bebek etkileşimi üzerine etkilerini inceleyen çalışmalarda farklı sonuçlar bulunmaktadır. Bu çalışmanın amacı doğum şekli ile doğum sonrası depresyon, algılanan sosyal destek ve maternal bağlanma arasındaki ilişkiyi incelemektir. Yöntem: Vajinal doğum yapan 40 kadın ve sezaryen doğum yapan 40 kadın çalışmaya alınmıştır. Depresif belirtilerinin taranmasında Edinburg Doğum Sonrası Depresyon Ölçeği (EDSDÖ), maternal bağlanmanın incelenmesinde Maternal Bağlanma Ölçeği (MBÖ) kullanılmıştır. Sosyal destek Çok Boyutlu Algılanan Sosyal Destek Ölçeği (ÇBASDÖ) ile değerlendirilmiştir. Bulgular: Doğum sonrası depresyon ve algılanan sosyal destek puanları açısından iki grup arasında fark bulunmamıştır. Diğer yandan MBÖ puanları SD yapan kadınlarda anlamlı olarak daha düşük bulunmuştur. Sonuç: Çalışmamızın sonuçları doğum şeklinin doğum sonrası depresyon gelişimi üzerine bir etkisinin olmadığını desteklemektedir. Bunun yanında SD'nin maternal bağlanma üzerine olumsuz bir etkisi olabilirObjective: There are contradictory findings in the literature about the effects of delivery type on postpartum depression and mother–infant interaction. The aim of this study was to investigate the relationship between delivery mode and postpartum depression, perceived social support, and maternal attachment.Method: Forty females, who had vaginal delivery (VD) and 40 females, who had cesarean delivery (CD) were recruited to participate in the study. Edinburgh Postpartum Depression Scale (EPDS) was used to screen depressive symptoms and Maternal Attachment Scale (MAS) was used to detect maternal attachment. Social support was assessed by using Multidimensional Scale of Perceived Social Support (MSPSS).Results: We found no significant differences in postpartum depression and perceived social support scores between the two groups. On the other hand, MAS scores were significantly lower in CD women.Discussion: Our findings support that delivery mode had no impact on the development of postpartum depression. However CD may have negative effect on maternal attachmen

Combination of Risperidone and Paroxetine for Inappropriate Sexual Behaviors in an Adolescent with Autism and Mental Retardation

Uygunsuz hiperseksüel davranışlar otizmi olan bireylerde sıklıkla bildirilmesine rağmen, yazında bu davranışların kontrol altına alınması ile ilgili yeterli bilgi bulunmamaktadır. Bu yazıda otistik bozukluğu ve zekâ geriliği olan bir ergen olguda aşırı uygunsuz cinsel davranışların risperidonparoksetin kombinasyonu ile tedavisi sunulmuştur. Otizmi olan kişilerde aşırı cinsel uğraşlar aile ve çevre için stres kaynağı oluşturabilir, bu nedenle uygun tedavi yaklaşımları önemlidir. (Nöropsikiyatri Arflivi 2012; 49: 311-313)Inappropriate hypersexual behaviors have been frequently reported in subjects with autism, however, literature on management of such behaviors in this group is very limited. In this paper, we describe an adolescent with autistic disorder and mental retardation who developed severe inappropriate sexual behaviors and has been treated successfully with risperidone-paroxetine combination. As presence of hypersexual behaviors in individuals with autism is a distressing factor for their family and social environment, appropriate management seems to be essential. (Archives of Neuropsychiatry 2012; 49: 311-313

Energy Management Strategy for a Microgrid Including All-in-One Electric Vehicle Station, Renewable Energy and Demand Response

Energy consumption in residential areas and transportation sector constitutes an important part of the global energy demand. Moreover, a large part of these energy demands is met from fossil resources. Recently, microgrid structures with renewable energy source (RES) have gained popularity. In this study, an optimum energy management strategy for a microgrid in which there are photovoltaic system, wind energy, flexible, loads, load serving entity (LSE), inelastic loads, and an all-inone electric vehicle (EV) station (AiOEVS) that can serve plugin EVs (PEVs), EVs with swappable battery (EVSB), and fuel cell EVs (FCEVs) is proposed. AiOEVS is equipped with a hydrogen tank and an integrated electrolyzer. Also, flexible loads in the microgrid are controlled within the scope of a demand response (DR) program to provide operational flexibility. In the study, the model that aims to minimize the total microgrid operation cost is handled with the mixed-integer linear programming (MILP) method. Test results prove the effectiveness of the proposed structure for economic operation

Çok düşük düoğum ağrıları olan bebeklerin doğum sonrası depresyon

Amaç: Çok düflük doum arlkl (ÇDDA) bir bebein doumu annesi için önemli bir yaflam olaydr. Bu bebeklerin annelerinin psikolojik stres açsndan yüksekrisk altnda olduu çeflitli arafltrmalarda gösterilmifltir. Bu çalflmann amac ÇDDA olan bebeklerin annelerinde depresif belirtilerin düzeyini arafltrmak veiliflkili etmenleri incelemektir. Yöntem: Çalflmaya 35 ÇDDA bebein (1500 gr) annesi, 35 düflük doumarlkl (DDA) bebein (1500-2500 gr) annesi ve 35 zamannda doan salklbebein (2500 gr) annesi olmak üzere toplam 105 bebek ve annesi alnmfltr. Annelerdeki doum sonras depresif belirtilerin incelenmesinde Edinburg Doum Sonras Depresyon Ölçei (EDDÖ) kullanlmfltr. Sosyal destek ise Çok BoyutluAlglanan Sosyal Destek Ölçei (ÇBASDÖ) ile deerlendirilmifltir. Bulgular: Ortalama EDDÖ puan ve yüksek depresyon puan olan (EDDÖ12) annelerin says ÇDDA olan bebeklerin annelerinde DDA olan bebeklerin vezamannda doan bebeklerin annelerine göre daha fazlayd. EDDÖ ile doumhaftas, doum arl ve alglanan sosyal destek arasnda negatif yönde kore-lasyon, EDDÖ ile hastanede kalfl süresi arasnda ise pozitif yönde korelasyonolduu görüldü. Düflük doum arl ve hastanede uzun süre kalfl doum son-ras depresyon için öngörücü deiflken olarak bulundu. Sonuç: Çok düflük doum arl olan bir bebein doumu ve ardndan hastan-eye yatrlmas annede psikolojik stres oluflturmaktadr. Çocuk hekimlerininÇDDA bebeklerin annelerinde depresif belirtiler konusunda daha dikkatliolmalar ve gerektiinde psikiyatri kliniine yönlendirmeleri yararl olabilir. (Nöropsikiyatri Arflivi 2012; 50: 30-33)Background: Giving birth to an infant with very low birth weight (VLBW) is a major life event for a mother. Several studies have shown that mothers of these infants are at greater risk of psychological distress. The aim of this study was to investigate the level of depressive symptoms and to determine the associated factors among mothers who have infants with VLBW. Methods: The sample consisted of 105 subjects: 35 mothers of VLBW infants (>1500 g), 35 mothers of low birth weight (LBW) infants (1500-2500 g), and 35 mothers of healthy term infants (<2500 g). The Edinburgh Postpartum Depression Scale (EPDS) was used to detect maternal depressive symptoms. Maternal social support was assessed by the Multidimensional Scale of Perceived Social Support (MSPSS). Results: The mean EPDS score and the number of mothers with high depressive scores (EPDS<12) were significantly higher in mothers of infants with VLBW than in mothers of LBW and term infants. EPDS score was negatively correlated with birth weight, gestational age, and perceived social support and positively correlated with duration of hospital stay in mothers of infants with VLBW. Low birth weight and long hospital stay were found as predictors of postpartum depression in mothers of infants with VLBW. Conclusion: The birth and subsequent hospitalization of an infant with very low birth weight evoke psychological distress in mothers. Pediatricians should be more careful about depressive symptoms of mothers of infants with VLBW and should refer for counseling when it is necessary. (Archives of Neuropsychiatry 2012; 50: 30-33

A Successful Pregnancy by Utilization of Gradually Increasing Low Dose Gonadotrophin Stimulation in a Modified Natural Cycle in Vitro Fertilization Procedure: Case Report

The modified natural cycle in vitro fertilization (MNC-IVF) treatment can be a promising method for poor responder patients especially in young patients with poor ovarian reserve. A 34-year-old primary infertile woman presented with a history of poor ovarian response and cycle cancellation following controlled ovarian hyperstimulation during an IVF-ET procedure two months ago. During MNC-IVF treatment with intracytoplasmic sperm injection (ICSI), gradually increasing doses of hMG for three days (totally 675 IU) have been administered accompanied by daily 0,25 mg cetrorelix. Following ovulation triggering, one oocyte was picked up and a good quality (grade 1) embryo was transferred on day 2. A clinical pregnancy was established with ultrasonography on sixth weeks of gestation. Acceptable pregnancy rates per embryo transfer, low medication cost, relatively low risk of complications and higher patient acceptability are the main advantages of MNC-IVF treatment as a feasible treatment option especially for poor responder patients

A New Approach for Grid-Connected Hybrid Renewable Energy System Sizing Considering Harmonic Contents of Smart Home Appliances

Even renewable energy sources provide several advantages, especially from an environmental point of view, where the world has faced great challenges in the last few decades; several negative issues also exist regarding the integration of renewable resources-based power production units in electric power systems. One of the main problems related to pivotal renewable energy resources such as solar, wind, etc., is their stochastic and uncontrollable nature in terms of power production. Therefore, this stochasticity in the supply side of the power system may pose many challenges for system operators. This issue is also problematic for smaller applications where the stochastic production by a main resource, such as a roof-top photovoltaic system, and load demand may not match perfectly at each time instant and therefore should be compensated by additional resources such as battery-based energy storage systems. Herein, the economic considerations to ensure minimum costs for such a hybrid system design are vital so as to increase the penetration of such systems. Therefore, the optimal sizing and planning of hybrid systems have recently gained increasing importance to enhance power system operation in the context of the smart grid paradigm. From a different perspective, harmonics are one of the most important power quality problems in system operations caused by widespread integration of power electronic loads with non-linear characteristics that should be considered. Thus, a new approach for grid-connected hybrid renewable energy system sizing is provided. In order to determine optimal capacities for photovoltaic (PV) and energy storage system (ESS) units for covering residential consumer demand, a mixed integer linear programming (MILP)-based formulation is presented. The main objective is minimizing total costs of the system consisting of investment, capital and maintenance cost functions. A daily power curve is created accurately with real measurements of non-linear loads considering harmonic contents of smart home appliances in Yildiz Technical University, Istanbul, Turkey. In addition, real radiation and temperature values are used in PV production as well as dynamic pricing schemes for realistic evaluations. Moreover, optimal sizing results are compared for both the harmonic-based power curve and rated power curve in terms of satisfying objective function