Modafinil dependence: A case with attention-deficit/hyperactivity disorder

Modafinil is generally known as a drug with low addiction potential. There are few case reports in the literature demonstrating that Modafinil, stated being capable of diminishing symptoms of attention deficit/hyperactivity disorder (ADHD), causes addiction. In the present article a Modafinil addicted ADHD case, consuming usurious doses (5,000 mg/per day) of Modafinil is presented. The case presented to our psychiatry outpatient clinic due to: requirement of in taking high dose Modafinil in order to achieve the initial effects, difficulty in obtaining the drug, irritability, anxiousness, sleep irregularities, fatigue and unpleasant vivid dreams when he did not use the drug. It was realized that the patient, himself increased doses of Modafinil incrementally, in order to keep its effects on attention symptoms at the same level. It has to be kept in mind that ADHD patients can develop Modafinil addiction. It is necessary to carry out systemic studies on this subject. © 2018 Korean Neuropsychiatric Association

The impact of synapsin III gene on the neurometabolite level alterations after single-dose methylphenidate in attention-deficit hyperactivity disorder patients

Objective: To investigate the neurometabolite level changes according to synapsin III gene rs133945G.A and rs133946C.G polymorphisms by using magnetic resonance spectroscopy (MRS) in patients with attention-deficit hyperactivity disorder (ADHD). Methods: Fifty-seven adults diagnosed with ADHD were recruited for the study. The participants were examined by single-voxel1H MRS when medication naïve and 30 minutes after oral administration of 10 mg methylphenidate (Mph). Those who had been on a stimulant discontinued the medication 48 hours before MRS imaging. Spectra were taken from the anterior cingulate cortex, dorsolateral prefrontal cortex, striatum, and cerebellum, and N-acetylaspartate (NAA), choline, and creatine levels were examined. For genotyping of the synapsin III gene polymorphisms, DNA was isolated from peripheral blood leukocytes. The effects of age, sex, and ADHD subtypes were controlled in the analyses. Results: After a single dose of Mph, choline levels increased significantly in the striatum of rs133945G.A polymorphism-GG genotypes (P=0.020) and NAA levels rose in the anterior cingulate cortex of rs133946C.G polymorphism-CG genotypes (P=0.014). Both rs133945G.A and rs133946C.G polymorphisms were found to statistically significantly affect the alteration of NAA levels in response to Mph in dorsolateral prefrontal cortex with two-way repeated measure of analysis of variance. Post hoc comparisons revealed a significant difference between CG and GG genotypes of rs133946C.G polymorphisms after Bonferroni adjustment (P=0.016). Conclusion: Synapsin III gene polymorphisms may be affecting the changes in neurometabolite levels in response to Mph in adult ADHD patients. Future studies are needed to confirm our findings. © 2016 Başay et al

Kendine zarar verme davranışı değerlendirme envanteri’nin Türkçe formunun geçerlik ve güvenilirlik çalışması

OBJECTIVE: Non-suicidal self-injury (NSSI) is defined as the repetitive deliberate destruction of one's body tissue without suicidal intent and is frequently repetitive. The aim of this study was to examine the psychometric properties of the Inventory of Statements About Self-injury (ISAS), a measure designed to comprehensively assess non-suicidal self-injury (NSSI). The ISAS assesses 13 functions of NSSI, as well as the frequency of 12 NSSI behaviors. METHOD: The ISAS was administered to 529 high school students who had performed at least one NSSI behavior. The internal consistency and test-retest reliability of the scale were examined; for construct validity, the relationship between the Turkish form of the ISAS and various criteria scales was examined, and confirmatory factor analysis (CFA) was conducted. RESULTS: Consistent with previous research, factor analysis of the functions scale confirmed the good-fit of the original's 2-dimension model (c;sup2;=243; s.d. = 59; NCI (c;sup2;/sd) = 4; RMSEA = 0.08 (.07-.09); CFI=0.97; NFI=0.97). In order to test the scale for construct validity, the Brief Symptom Inventory and Suicide Probability Scale were administered to participants, in addition to the ISAS, and the correlations with clinical constructs (e.g., suicidality, depression, anxiety) were in the expected direction. Also the reliability analysis revealed that the ISAS subscales demonstrated high internal consistency. CONCLUSION: In the light of the findings, it was concluded that the Turkish version of ISAS could be used as a reliable and valid tool in assessing non-suicidal self-injury in research and treatment contexts.Amaç: “İntihar niyeti taşımayan” kendine zarar verme davranışı (KZVD), yaşamını sonlandırma amacı olmaksızın kişinin kasıtlı olarak beden dokularına zarar vermesi olarak tanımlanmıştır ve sıklıkla tekrarlayıcı biçimdedir. Bu çalışmanın amacı, Kendine Zarar Verme Davranışı Değerlendirme Envanteri’nin (KZVDDE) psikometrik özelliklerinin incelenmesidir. Envanter, “intihar niyeti taşımayan” kendine zarar verme davranışının kapsamlı değerlendirilmesi için geliştirilmiştir. Envanter, 12 tip KZVD yanı sıra bu davranışların işlevlerini de değerlendirmektedir. Yöntem: Envanter, “en az bir KZVD gösteren” 529 lise öğrencisine uygulanmıştır. Envanterin, test-tekrar test güvenilirliği ile iç tutarlılığı araştırılmış; yapı geçerliği bağlamında kriter ölçeklerle ilişkileri incelenmiş ve doğrulayıcı faktör analizi yapılmıştır. Bulgular: Önceki araştırma sonuçları ile tutarlı biçimde, envanterin işlevler bölümü için yapılan faktör analizi, özgün envanterle örtüşen iki faktörlü iç yapıyı doğrulamıştır (c²=243; ss= 59; NCI (c²/ss)=4; RMSEA =0,08 (0,07-0,09); CFI=0,97; NFI=0,97). Katılımcılara, envanterin yanı sıra yine yapı geçerliği bağlamında, Kısa Semptom Envanteri ve İntihar Olasılığı Ölçeği uygulanmış ve klinik yapılar (intihar, depresyon, kaygı gibi) ile beklenen yönde ilişkiler bulunmuştur. Güveni lirlik analizleri de, envanterin iç tutarlılığı yüksek alt boyutlara sahip olduğunu göstermiştir. Sonuç: Araştırmanın bulgularına göre, KZVDDE’nin Türkçe formunun araştırma ve tedavi alanında KZVD’nin değerlendirilmesinde güvenilir ve geçerli bir ölçüm aracı olarak kullanılabileceği düşünülmektedir

Acute dystonia following a switch in treatment from atomoxetine to low-dose aripiprazole

The present report describes the cases of a 17-year-old male patient and a 13-year-old female patient who developed acute dystonia following the administration of low-dose aripiprazole (5 mg/day) after the cessation of atomoxetine treatment. Although aripiprazole-induced dystonia has been previously reported in the literature, it is rare, and most of these cases were associated with doses higher than 5 mg/day. Furthermore, both of the patients in the present study discontinued atomoxetine prior to the initiation of aripiprazole treatment; thus, this report also discussed the possible mechanisms underlying the manifestation of dystonia from the perspective of neurotransmitter activity. Copyright © 2016, Korean College of Neuropsychopharmacology

Alkol- madde kullanım bozuklukları olan ergenlerin kişilik özellikleri

Objective: Personality characteristics are found to be related with substance use initiation, substance abuse, substance dependence and substance use continuance. The aim of this study is to investigate the personality characteristics of adolescents with alcohol/substance use disorder (ASUD). Methods: Sixty-nine adolescents with ASUD, aged between 16 and 18 were compared with 69 adolescents with similar sociodemographic properties and without ASUD. Minnesota Multiphasic Personality Inventory (MMPI) was used to assess personality traits. Results: Adolescents with SUD had higher scores for psychopathology (F), hypochondriasis, hysteria, depression, psychopathic deviation, paranoia, psychasthenia, schizophrenia, and hypomania scales and lower score for defensiveness (K) scale when compared with the control group. Discussion: Adolescents with ASUD have insufficient defense mechanisms and negative personality characteristics. Personality characteristics of these adolescents should be considered in the treatment and follow up periods.Amaç: Kişilik özellikleri madde kullanmaya başlama, madde kötüye kullanımı, madde bağımlılığı ve madde kullanmayı sürdürmeyle ilişkili bulunmuştur. Bu çalışmanın amacı alkol/madde kullanım bozukluğu (AMKB) olan ergenlerin kişilik özelliklerini incelemektir. Yöntem: AMKB tanısı konulmuş 16-18 yaşları arasında 69 ergen ile benzer sosyodemografik özellikler gösteren AMKB olmayan 69 ergen karşılaştırılmıştır. Kişilik özelliklerini değerlendirmek için Minnesota Çok Yönlü Kişilik Envanteri (MMPI) kullanılmıştır. Sonuçlar: MMPI psikopataloji, hipokondri, histeri, depresyon, psikopatik sapma, paranoya, psikasteni, şizofreni ve hipomani alt ölçeklerinde AMKB olan ergenler kontrol grubuna göre yüksek puan alırken; savunucu tutum (K) alt ölçeğinde kontrol grubuna göre anlamlı düzeyde düşük puan almıştır. Tartışma: AMKB olan ergenlerin yetersiz savunma düzenekleri ve olumsuz kişilik özellikleri vardır. AMKB olan ergenlerin kişilik özellikleri tedavi ve izlemede dikkate alınmalıdır

Personality characteristics of adolescents with substance use disorders

Objective: Personality characteristics are found to be related with substance use initiation, substance abuse, substance dependence and substance use continuance. The aim of this study is to investigate the personality characteristics of adolescents with alcohol/substance use disorder (ASUD). Methods: Sixty-nine adolescents with ASUD, aged between 16 and 18 were compared with 69 adolescents with similar sociodemographic properties and without ASUD. Minnesota Multiphasic Personality Inventory (MMPI) was used to assess personality traits. Results: Adolescents with SUD had higher scores for psychopathology (F), hypochondriasis, hysteria, depression, psycho-pathic deviation, paranoia, psychasthenia, schizophrenia, and hypomania scales and lower score for defensiveness (K) scale when compared with the control group. Discussion: Adolescents with ASUD have insufficient defense mechanisms and negative personality characteristics. Personality characteristics of these adolescents should be considered in the treatment and follow up periods. © 2016, Cukurova University, Faculty of Medicine. All rights reserved