Psychiatric disorders detected among dermatology inpatients who are in need of psychiatric consultation

Kliniığimizde çeşitli dermatolojik şikayetlerle yatan hastalardan psikiyatrik konsültasyon gerektirenlerdeki ruhsal bozuklukları saptamak. Ocak 1996 - Aralık 2001 tarihleri arasında Celal Bayar Üniversitesi Tıp Fakültesi Dermatoloji kliniığinde çeşitli tanılarla yatarak tetkik ve tedavi edilen 394 hasta retrospektif olarak deığerlendirildi. Psikiyatri kliniıği tarafından deığerlendirilen 66 hasta çalışma grubuna dahil edildi. Çalışma grubuna alınan 66 yatan hastanın 42'si (% 63.6) kadın, 24'ü (% 36.4) erkekti.Yaşları 15 ile 79 arasında deığişen hastaların yaş ortalaması 43.74 14.34 idi. Hastaların servisimizde yatış süreleri 3 ile 150 gün arasında deığişmekte olup, ortalama yatış süresi 22.57 26.71 gündü. Psikiyatri kliniığince deığerlendirilen hastaların 10'unda (%15.2) herhangi bir patoloji saptanmadı. 27'si (%40.9) depresyon, 6'sı (%9.1) BTA (başka türlü adlandırılamayan) anksiyete bozukluığu, 6'sı (%9.1) obsesif kompulsif bozukluk, 5'i (%7.6) karışık anksiyete-depresif bozukluk, 3'ü (%4.5) distimik bozukluk, 2'si (%3.0) major depresyon, 1'i (%1.5) konversiyon bozukluığu, 1'i (%1.5) obsesif kompulsif bozukluk ve depresyon, 1'i (%1.5) mikst anksiyete-depresyon ve obsesif kompulsif bozukluk, 1'i (%1.5) konversiyon bozukluığu ve reaktif depresyon, 1'i (%1.5) atipik depresyon, 1'i (%1.5) konversiyon bozukluığu ve distimik bozukluk, 1'i (%1.5) mental retardasyon tanısı aldı. Dermatolojik hastalıklarla çeşitli psikiyatrik bozuklukların birlikteliığinin oldukça yüksek olduığu ve bu konunun gözardı edilmemesi gerektiıği sonucuna varıldı.We aimed to determine psychiatric disorders detected among dermatology inpatients who are in need of psychiatric consultation. 394 dermatology inpatients, who were treated between January 1996 and December 2001 in Celal Bayar University Hospital, were evaluated retrospectively. 66 patients, examined by psychiatrists were included in the study. Of 66 patients 42 (63.6%) were female and 24 (36.4%) were male. Mean age of the patients was 43.74 14.34. Mean hospitalization period was 22.57 26.71 days, ranging from 3 to 150 days. According to the psychiatric evaluations, no psychiatric abnormality was found in 10 (15.2%) patients. On the other hand, there was depression in 27 patients (40.9%), anxiete disorder, that can not be named otherwise, in 6 (9.1%), obsessivecompulsive disorder in 6 (9.1%), mixed anxiete and depressive disorder in 5 (7.6%), distimic disorder in 3 (4.5%), major depression in 2 (3.0%), conversion disorder in 1 (1.5%), obsessive-compulsive disorder and depression in 1 (1.5%), mixed anxiete-depression and obsessive-compulsive disorder in 1 (1.5%), conversion disorder and reactive depression in 1 (1.5%), atypic depression in 1 (1.5%), conversion disorder and distimic disorder in 1 (1.5%), and mental retardation in 1 (1.5%) successively. As dermatological diseases are associated with psychiatric disorders quite often, one should keep this in mind while approaching to patients with dermatologic diseases

Psychopathology, alexithymia, and self-esteem in obese patients

Amaç: Obezite kronik ve ciddi bir halk sağlığı sorunudur. Kişilerin sağlıkla ilgili yaşam kalitesini birçok yoldan etkileyen yaygın bir bozukluktur. Sıklıkla depresyona ve diğer psikiyatrik bozukluklara yol açar. Bu araştırmada obez hastalarda psikiyatrik tanılar, depresyon ve anksiyete düzeyleri, aleksitimi ve benlik saygısının araştırılması amaçlanmıştır. Yöntem: Araştırma grubunu Endokrinoloji polikliniğine başvuran hastalardan obezite tanısı konan ardışık 50 hasta oluşturmuştur. Hastalara DSM-IV I. eksen bozukluklarını araştırmak için yapılandırılmış klinik görüşme çizelgesi klinik versiyonu (SCIDI) uygulanmıştır. Hastalarda sosyodemografik bilgi formu, Hamilton Depresyon Derecelendirme Ölçeği (HDDÖ), Hamilton Anksiyete Değerlendirme Ölçeği (HADÖ), Beck Depresyon Envanteri (BDE), Hastane Anksiyete ve Depresyon Ölçeği (HAD), Toronto Aleksitimi Ölçeği (TAÖ), Rosenberg Benlik Saygısı Ölçeği (RBSÖ) kullanılmıştır. Ölçek puanları ile beden kitle indeksi (BKİ) ilişkisi için t-testi uygulanmıştır. Sonuçlar: Beden kitle indeksi ortalaması 37.84±6.51 kg/m2(aralık:30.0-52.0) bulunmuştur. Hastaların ortalama yaşı 41.62±11.80 olarak saptanmıştır. Hastaların %90'ı (n=45) kadın, %48'i (n=24) ev kadını, %40'ı (n=20) ilkokul mezunu, %72'si (n=36) evli olarak saptanmıştır. Hastaların 21'inde (%42) DSM-IV'e göre psikiyatrik tanı saptanmıştır. Özgül fobi en sık psikiyatrik bozukluk olarak belirlenmiştir (n=9, %18). Hastaların TAÖ ve RBSÖ puanları sırasıyla 9.70±3.34 ve 1.26±1.38 olarak bulunmuştur. BKİ ile ölçek puanları arasında istatistiksel olarak anlamlı bir ilişki bulunamamıştır. Tartışma: Obezi6.51 kg/m2 (aralık:30.0-52.0) bulunmuştur. Hastaların ortalamtede psikiyatrik durum ve risk etkenleri arasındaki ilişkiyi saptayabilmek için daha fazla araştırmanın yürütülmesi gerekir. Bu nedenle özellikle daha detaylı ve uzun süreli araştırmalara gereksinim vardır.Objective: Obesity is a chronic disorder and a serious public health problem. Obesity is a common disorder that affects a person's health-related quality of life in a number of ways. Obesity often leads to reactive depression and other psychiatric disorders. In this study, it is aimed to investigate psychiatric diagnosis, levels of depression and anxiety, alexithymia, and self-esteem in a group of obese patients. Methods: The sample was consisted of 50 obese persons consecutively admitted to the Celal Bayar University Hospital Endocrinology Department. The trained clinical psychiatrists interviewed the patients with the Structural Clinical Interview for DSM-IV (SCID). The patients were applied to the sociodemographic data form, Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), Beck Depression Inventory (BDI), Hospital Anxiety and Depression Rating Scale (HADRS), Toronto Alexithymia Scale (TAS), Rosenberg Self Esteem Scale (RSES). The influence of body mass index (BMI) of the patients on scales scores were investigated by t-test. Results: The mean BMI was 37.84±6.51 kg/m2 (min:30.0, mak:52.0). The mean age was 41.62±11.80. Of the whole patients, 90% (n=45) was women. 48% (n=24) of the patients were housewife. 40% (n=20) of the patients were graduated from primary school. 72% (n=36) of the patients were married. Twenty-one patients (42%) had a current DSM-IV diagnosis. It was demonstrated that specific phobia was the most common psychiatric disorder (n=9, 18%). The mean scores of TAS and RSES were respectively 9.70±3.34 and 1.26±1.38. The positive correlation between the BMI and the scales scores wasn't statistically significant. Discussion: More studies is necessary to indicate between psychopathology and risk factors in obesity. For this reason, more detailed and longitudinal studies are especially needed

Compulsive water drinking: A case report

Kompulsif su içme psikiyatrik bozukluklarda sık rastlanan bir klinik belirti olmasına rağmen, tek başına nadir görülür. Bu sendrom "kompulsif su içme", "psikojenik polidipsi" ve "kendisinin yol açtığı su intoksikasyonu"olarak adlandırılır. Altında yatan neden açık değildir. Nedenleri arasında olası hipotalamik bir kusur, uygunsuz antidiüretik hormon salınımı ve antipsikotik tedavi olabilir. Aşın su içme hiponatremi gelişmedikçe iyi tolere edilir. Sıvı kısıtlaması ile serotonin geri alım inhibitörieri, atipik antipsikotikler ve propranololden oluşan ilaç tedavisi başlıca tedavi yöntemleridir. Bu olgu sunumunda kompulsif su içmesi olan 20 yaşında gebe bir kadın hasta sunulmuştur. Aşın su içmenin aile yaşamındaki çatışma ile, özellikle babanın baskısı ile ilişkili olabileceği düşünülmüştür. Günlük su alımı 15 litredir. Tanı ve tedavisi tartışmalı bir olgudur. Tanı psikiyatrik değerlendirmeler sonucunda konmuştur.Compulsive water drinking is a well-recognized clinical entity that is often seen in individuals with psychiatric disorders, but alone is rare. This syndrome is called "compulsive water drinking", "psychogenic polydipsia", and "self-induced: water intoxication". The underlying reason of this entity is unclear. These include a possible hypothalamic defect, the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), and antipsychotic medication. The excessive water drinking is well tolerated unless hyponatremia is developed. Treatment strategies include fluid restriction and medications, such as serotonin reuptake inhibitors, atypical antipsychotics, and propranolol. This report describes a case of compulsive water drinking in a 20-year-old pregnant woman. At primarily, the excessive water drinking is created by the conflicts in the family life, especially with the aggress/on of the father. The water intake reached IS litres per day. The diagnosis and management are discussed. Compulsive water drinking was finally diagnosed following psychiatric evaluation

Etiology of Food Addiction

Food addiction is a new topic of focus in the scientific literature. Food intake might be concerned as food addiction in some cases, especially in obese cases and over-eaters. Addiction like behaviours are commonly observed mong these people. Recent animal, epidemiological, clinical and genetic studies partly shows the clinical validity of food addiction while the neurobiological studies focused on the similarity between the reward systems present in obesity and drug addiction. However some studies still emphasizes the differences between two. The aim of this article was to review clinical and biological aspects of etiological perspectives of food addiction via available clinical, preclinical and genetic studies

Etiology of Food Addiction

Food addiction is a new topic of focus in the scientific literature. Food intake might be concerned as food addiction in some cases, especially in obese cases and over-eaters. Addiction like behaviours are commonly observed mong these people. Recent animal, epidemiological, clinical and genetic studies partly shows the clinical validity of food addiction while the neurobiological studies focused on the similarity between the reward systems present in obesity and drug addiction. However some studies still emphasizes the differences between two. The aim of this article was to review clinical and biological aspects of etiological perspectives of food addiction via available clinical, preclinical and genetic studies

Şizofreni ile kavum septum pellusidum arasındaki ilişki: Bir olgu sunumu

Kuzu, Duygu (Arel Author)Şizofreni ile kavum septum pellusidum arasındaki ilişki: Bir olgu sunumu Lateral ventriküllerin medial duvarını oluşturan septum pellucidum iki laminadan oluşan ince bir tabakadır. Kavum septum pellucidum (KSP), septum pellucidumun iki yaprağı arasındaki bir boşluktur. KSP'un şizofreni ile ilişkili nörogelişimsel bir anomali olduğu düşünülmektedir. Normal fetal gelişimde septum pellucidumun oluşumu hipokampus, amigdala, korpus kallosum, septal nükleus gibi komşu limbik yapılarla eş zamanlı olmaktadır. Bu yüzden septum pellucidumda saptanan anatomik farklılıklar, komşu anatomik yapıların embriyonal gelişim bozukluklarını yansıtabilir. Birkaç manyetik rezonans görüntüleme çalışmasında, şizofreni hastalarında normal kişilere göre daha yüksek prevalansta geniş KSP saptanmıştır. Psikiyatrik bozukluklarla ilgili literatüre baktığımızda KSP'nin en çok şizofreni ile bağlantılı olduğunu görebiliriz. Geniş KSP şizofreninin etyolojik nedenlerinden biri olarak gösterilen nörogelişimsel modeli desteklemektedir. Biz bu olgu sunumunda, manyetik rezonans görüntüleme yöntemi ve nörobilişsel yeti yitimini tartıştıkThe relationship between schizophrenia and cavum septum pellucidum: a case studySeptum pellucidum that forming the medial wall of the lateral ventricles, a thin layer is formed by two laminae. Cavum septum pellucidum (CSP), a space between the two leaflets of the septi pellucidi, is thought to be a neurodevelopmental anomaly associated with schizophrenia. In normal fetal development, the formation of septum pellucidum occurs at the same time with the development of the neighboring limbic system structures such as hippocampus, amygdala, corpus callosum, septal nucleus. Therefore, the anatomical differences that are detected in the septum pellucidum may reflect the embryonal development disorders of the adjacent anatomical structures. Several magnetic resonance imaging studies have reported a higher prevalence of enlarged CSP in patients with schizophrenia than in normal subjects. In the literature of psychiatric disorders, CSP is most associated with schizophrenia. Wide CSP may support the neurodevelopmental etiology of schizophrenia. In this report we present a schizophrenia case. And we tried to discuss the patient’s clinical appearance and neurocognitive disabilit

Relationships between nicotine craving, orexin-leptin levels and temperament character traits among non-treatment seeking health professionals

BACKGROUND: Repeated cigarette use in individuals generally occurs due to the craving for smoking. Orexin-leptin hormones and temperament character traits are thought to be important factors affecting nicotine craving. OBJECTIVE: The aims of this study were to determine orexin-leptin blood levels, which appear in nicotine deprivation, in health professionals who were diagnosed as having tobacco use disorder in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) and to assess the temperament-character traits of the same group and to provide biologic and psychotherapeutic data for the treatment of tobacco abuse. METHODS: The study sample consisted of faculty of medicine students and resident physicians who were smokers (n = 40). The control group comprised medical students and resident physicians who were non-smokers (n = 40). The Sociodemographic and Clinical Information Form, DSM-IV SCID-I Clinical Version, and Temperament and Character Inventory (TCI) were applied to both groups. Substance Craving Scale (SCS) and Fagerstrom Test for Nicotine Dependence were applied only smoking group. Blood samples were taken for plasma orexin and serum leptin levels for both groups. RESULTS: The plasma orexin levels were lower in the smokers group (p < .001). No statistically significant relations were determined between the SCS and plasma orexin and serum leptin levels in the smoking group. No significant differences were determined between the leptin (U = 119.5, p = .33) and orexin (U = 99, p = .11) levels of the heavy and very heavy smokers. The total points of novelty seeking (NS), and NS3 and NS4 subscale points in the TCI of the smoking group (p = .003, p = .003, p = .002), and the self-directedness (SD) SD2 and SD5 (p = .02, p = .01) subscale points, and total cooperativeness points (TC), and C4 and C5 subscale points (p = .001, p = .002, p = .001) of the non-smoking group were found as high. CONCLUSIONS/IMPORTANCE: Differences were detected between the smokers and non-smokers in TCI scale subgroups and in terms of orexin levels. These results will greatly assist in the fight against craving that appears as a result of smoking cessation. Orexin appears to be more specific for nicotine craving than leptin. It seems more likely that the quest for the treatment of craving will continue through orexin. Temperament and personality traits are important for determining psychotherapeutic and supportive approaches to the release of tobacco and tobacco products. A number of studies investigating monoaminergic mechanisms indirectly related to orexin and leptin are required to research temperament, which has a greater genetic burden

The relationship between symptoms and patient characteristics among psoriasis patients

Background: Pruritus is a common symptom of many dermatological and systemic diseases. It is a common complaint among patients with psoriasis of the chronic plaque type. Patients with pruritus suffer from more severe psoriasis although some authors did not find a significant relationship between pruritus intensity and psoriasis severity. Aims: In this study, we aimed to investigate the relationship between clinical features and symptoms among psoriasis patients. And also we aimed to evaluate whether the severity of disease, depression and quality of life scores could effect these symptoms or not. Methods: Eighty seven patients with psoriasis were enrolled in this study. Epidemiological data of patients were noted. Clinical symptoms, such as pruritus, pain, burning, exudation, bleeding, weakness, etc. were interrogated. The answers to these questions were classified as ′never′, ′rare′, ′sometimes′, ′often′ and ′all the time′. Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), Hamilton Anxiety-Depression Scale (HAD) were calculated for each patient. PASI and DLQI scores were classified as ≥ and < 10. Results: We found that the most frequent symptom was pruritus (96.6%). Other frequent symptoms were burning (56.3%), exudation (56.3%) and bleeding (49.4%). Hurting, sensitiveness and bothering were more frequent in women. Percentages of hurting, pain, exudation and weakness symptoms had been increasing with age. Frequency of weakness was significantly high in PASI ≥ 10 patients. Conclusion: Pruritus is a very common symptom in psoriasis. Burning, exudation and bleeding are also common symptoms seen in psoriasis. New scoring systems including symptoms of psoriasis patients may be developed for evaluating the severity of the disease

Evidence of associations between brain-derived neurotrophic factor (BDNF) serum levels and gene polymorphisms with tinnitus

Background: Brain-derived neurotrophic factor (BDNF) gene polymorphisms are associated with abnormalities in regulation of BDNF secretion. Studies also linked BDNF polymorphisms with changes in brainstem auditory-evoked response test results. Furthermore, BDNF levels are reduced in tinnitus, psychiatric disorders, depression, dysthymic disorder that may be associated with stress, conversion disorder, and suicide attempts due to crises of life. For this purpose, we investigated whether there is any role of BDNF changes in the pathophysiology of tinnitus. Materials and Methods: In this study, we examined the possible effects of BDNF variants in individuals diagnosed with tinnitus for more than 3 months. Fifty-two tinnitus subjects between the ages of 18 and 55, and 42 years healthy control subjects in the same age group, who were free of any otorhinolaryngology and systemic disease, were selected for examination. The intensity of tinnitus and depression was measured using the tinnitus handicap inventory, and the differential diagnosis of psychiatric diagnoses made using the Structured Clinical Interview for Fourth Edition of Mental Disorders. BDNF gene polymorphism was analyzed in the genomic deoxyribonucleic acid (DNA) samples extracted from the venous blood, and the serum levels of BDNF were measured. One-way analysis of variance and Chi-squared tests were applied. Results: Serum BDNF level was found lower in the tinnitus patients than controls, and it appeared that there is no correlation between BDNF gene polymorphism and tinnitus. Conclusions: This study suggests neurotrophic factors such as BDNF may have a role in tinnitus etiology. Future studies with larger sample size may be required to further confirm our results