CORRELATION AMONG EXPERIENTIAL AVOIDANCE, ANXIETY SENSITIVITY AND BEHAVIORAL INHIBITION SYSTEM IN GENERALIZED ANXIETY DISORDER AND PANIC DISORDER PATIENTS

Purpose: This study aimed to analyze the concepts of experiential avoidance, anxiety sensitivity and behavioral inhibition system through healthy volunteers and patients diagnosed with anxiety disorder. It was planned to analyze and evaluate the correlation among the levels of experiential avoidance, anxiety sensitivity and behavioral inhibition system in various anxiety groups. Method: Within the scope of this study, clinical interviews were carried out with patients who sought treatment at the Psychiatry Department of the Hospital of Balıkesir University Medical Faculty. The study included 50 Generalized Anxiety Disorder (GAD) patients and 50 Panic Disorder (PD) patients who fulfilled the study criteria and accepted to participate in the study. A voluntary control group of 50 individuals with similar age and gender with the patients was formed. The participants were evaluated through the Acceptance and Action Questionnaire-II (AAQ-II), Behavioral Inhibition System/Behavioral Approach System Scale (BIS/BAS Scale), and Anxiety Sensitivity Index-3 (ASI-3). Results: In this study, the anxiety sensitivity, behavioral inhibition system sensitivity and experiential avoidance levels were all found to be higher in both the GAD and PD patients than the controls. On the other hand, the scale scores did not significantly differ between the GAD patients and PD patients. Positive correlations were determined among anxiety sensitivity, experiential avoidance and behavioral inhibition system. Our data provided findings supporting that the development of anxiety disorders entails increased anxiety sensitivity, behavioral inhibition system sensitivity and experiential avoidance levels. Discussion: The literature has shown, through separate studies, a correlation among experiential avoidance, anxiety sensitivity and behavioral inhibition system as well as a correlation between these concepts and anxiety disorders, and this study handled them altogether to reveal their correlation with anxiety in a clinical environment

Relationship between panic disorder and plasma neuropeptide-S level

Background: Panic disorder has long been associated with the changes in various neurotransmitters, such as Neuropeptide-S (NPS). Objective: In this study we aimed to determine whether there is a relationship between blood NPS levels and panic disorder. Methods: Twenty nine patients with panic disorder and thirty two healthy control subjects who were age and gender matched were enrolled to the study. Blood samples were taken from participants and plasma NPS levels were quantified by using an ELISA kit. Results: In the study group, median NPS blood level was 16.7 pg/mL and in the control group it was 32.5 pg/mL. There was a statistically significant difference (p = 0.021). Using receiver operating characteristics (ROC) curve, sensitivity and specificity of NPS blood level, for diagnosing panic disorder was calculated, and it was found 79.3% and 56.25% respectively (AUC:0.672, 95% CI: 0.540-0.787). Discussion: Malfunction at the NPS modulatory system in the cortical areas (which is causing excitations in brain areas, such as amygdala and hypothalamus) does not only increase anxiety symptoms and risk of panic disorder but also causes panic disorder patients to have lower plasma NPS levels than the control group. Therefore it can be argued that such malfunction can be treated with a systemic treatment

Relationship between Alexithymia and Coping Attitudes in Generalized Anxiety Disorder

Among anxiety disorders, the incidence of alexithymic features is found in a wide range of 12.5-58%, and it is a personality trait that can also be seen in healthy individuals. Our study investigated the relationship between alexithymic features and coping attitudes in patients with generalized anxiety disorder. Forty patients diagnosed with Generalized Anxiety Disorder and 39 healthy volunteers participated in the study. Participants were divided into groups using the Toronto Alexithymia Scale, and the Hamilton Anxiety Scale and Coping Attitudes Scale were applied to all participants. Nineteen patients with alexithymia and Generalized anxiety disorder, 21 patients with Generalized anxiety disorder without alexithymia, and 39 healthy volunteers participated in this study. Statistically significant differences were observed between the problem-focused coping and emotion-focused coping subscale scores, but there was no difference in dysfunctional coping styles between the three groups. In the correlation analysis performed to determine the relationship between the total alexithymia and Coping attitudes subscale scores, there was a moderate negative correlation between the alexithymia scores and problem-focused (r=-0.442) and emotion-focused coping (r=-0.425) subscale scores. Alexithymia is often accompanied by generalized anxiety disorder and negatively affects coping attitudes

VITAMIN D LEVELS AND VITAMIN D RECEPTOR GENE POLYMORPHISM IN MAJOR DEPRESSION

Background: The aim of this study is to evaluate vitamin D levels and rs2228570 (FokI) polymorphism of vitamin D in patients with established diagnosis of major depressive disorder in order to investigate the impact of vitamin D levels and genetic polymorphisms on etiology and/or severity of the disease. Subjects and methods: The study included 86 patients who were diagnosed with major depressive disorder in Hospital of Balıkesir University Faculty of Medicine, Department of Psychiatry, and 89 healthy volunteers with similar age, sex, education level and BMI. Psychiatric diagnosis was established by using Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). For clinical evaluation, sociodemographic data form, Hamilton Depression Rating Scale, Hamilton Anxiety Scale were used. Blood samples were drawn after 12 hours of fasting from the patients volunteered and the control group who were given their informed consent for participation in the study. Vitamin D levels were determined by using the method of ECLIA (Electrochemiluminescent immunoassay). Genotype analysis was performed using the method of Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP). Results: In our study, median vitamin D levels (min-max) of the patient and control groups were 10.3 ng/mL (3.0-42.1) and 11.4 ng/mL (3.0-38.8), respectively. Statistically significant differences as for vitamin D levels between groups were not detected (p=0.729). Similiarly no statistically significant difference between groups in genotype distribution was observed (p=0.396). Conclusion: In conclusion, our findings do not support the relationship between depression, vitamin D levels and Fok 1 polymorphism of vitamin D receptor. To test these hypotheses in the light of literature we need further studies to be performed with large number of patients

Depression, Anxiety Disorders, Quality of Life and Stress Coping Strategies in Hemodialysis and Continuous Ambulatory Peritoneal Dialysis Patients

Objective: In this study, we aimed to assess patients with chronic kidney disease on hemodialysis or continuous ambulatory peritoneal dialysis (CAPD) and to compare them with matched controls for depression, anxiety disorders, quality of life, and stress coping strategies and to estimate the comorbidity of psychiatric disorders and related risk factors

Alprazolam induced anxiety

Anksiyete bozuklukları toplumda en yaygın görülen, sosyal, mesleki ya da diğer günlük işlevlerde kayıplara yol açan ruhsal bozukluklardır. Anksiyete semptomlarının azaltılması amacıyla yaygın olarak kullanılan benzodiazepinlerden biri alprazolamdır. Yazımızda paradoksik bir şekilde alprazolam tedavisi ile anksiyete artışı ortaya çıkan bir olgu sunulmuştur.Anxiety disorders are the most prevalent mental disorders in the general population. Anxiety cause impairment in social, occupational or other daily functioning. Alprazolam decreases anxiety symptoms and is widely used for this indication. In this paper, it is reported a case that exhibits anxiety paradoxically with alprozolam

Depression, anxiety, stress coping strategies of the mothers of mentally-disabled children

Amaç: Bu çalışma, zihinsel engelli çocuğu olan annelerin depresyon, anksiyete ve başa çıkma tutumlarını değerlendirmek amacıyla yapılmıştır. Gereç ve Yöntem: Çalışmaya zihinsel engelli çocuk anneleri arasından 50 ve kontrol olarak sağlıklı çocuk annesi 50 kişi alınmıştır. Tüm katılımcılarla psikiyatrik görüşme yapılmış, ilk görüşmede DSM-IV Eksen-I Bozuklukları için Yapılandırılmış Klinik Görüşme (SCID-I) kullanılarak katılımcılarda psikiyatrik bozukluk varlığı araştırmacılar tarafından değerlendirilmiştir. Her katılımcıya Hamilton Depresyon Derecelendirme Ölçeği (HAM-D) ve Hamilton Anksiyete Değerlendirme Ölçeği (HAM-D) uygulanmıştır. Ayrıca katılımcılara sorunla başa çıkma tutumlarını değerlendirmek için Başa Çıkma Tutumları Ölçeği (COPE) yapılmıştır. Bulgular: Zihinsel engelli çocuk annelerinin Hamilton Depresyon Derecelendirme Ölçeği’nden aldıkları puanların ortancası (en düşük-en yüksek) 6.0 (1-23), kontrol grubunun ise (en düşük- en büyük) 4.5 (0-19) olup aradaki fark istatistiksel olarak anlamlı bulunmuştur (p<0.05). Zihinsel engelli çocuk annelerinin Hamilton Anksiyete Değerlendirme Ölçeği’nden aldıkları puanların ortancası (en düşük -en büyük) 7.0 (2-41), kontrol grubunun ise 5.0 (0-16) olup istatistiksel olarak anlamlı derecede farklı bulunmuştur (p<0.05). Çalışmaya katılan anneler sorunla başa çıkma tutumlarına göre değerlendirildiklerinde, inkar ve davranışsal olarak boş vermeyi zihinsel engelli çocuk annelerinin, kontrol grubundaki annelere göre daha çok kullandıkları bulunmuştur. Sonuç: Aileler bu yoğun stresli, uzun süreli sorunla baş etmede çoğunlukla yetersiz kalmakta ve çeşitli davranışsal ve duygusal sorunlar yaşamaktadırlar. Bu nedenle ailelerin özelikle de çocuğa primer bakım veren annelerin desteklenmesi önemlidir.Objective: This study is planned in order to assess the depression, anxiety and stres coping strategies of the mothers whose children are mentally-disabled Material and Methods: 50 patients among the mothers of mentally-disabled children and 50 controls among the mothers of healthy children, were involved in the study. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was used to assess current psychiatric disorders. Hamilton Depression Rating Scale (HAM-D) and Hamilton Anxiety Rating Scale (HAM-D) were applied. Besides, Stress Coping Strategies Scale (COPE) was applied in order to assess the patients’ strategies of coping with problems. Results: The median score (minumum-maximum) which they got from Hamilton Depression Rating Scale is 6 (1-23) which is evaluated statistically-significant compared to the score of the control group of which score is 4.5 (0-19). The median score which the patients got from Hamilton Anxiety Rating Scale is 7.0 (2-41) which is evaluated statisticallysignificant compared to the score of control group of which score is 5.0 (0-16). It is found out that the patients involved in the study use denial and behavioral ignorance more than the control group when they are assessed according to their strategies of coping with problems. Conclusion: Families are mostly inadequate in the process of coping with this dense, stressful and long-term problem and they have some different behavioral and emotional problems. Therefore, it is important to support the families, especially the mothers who give primary care to the child

Depression, anxiety, stress coping strategies of the mothers of mentally-disabled children

Amaç: Bu çalışma, zihinsel engelli çocuğu olan annelerin depresyon, anksiyete ve başa çıkma tutumlarını değerlendirmek amacıyla yapılmıştır. Gereç ve Yöntem: Çalışmaya zihinsel engelli çocuk anneleri arasından 50 ve kontrol olarak sağlıklı çocuk annesi 50 kişi alınmıştır. Tüm katılımcılarla psikiyatrik görüşme yapılmış, ilk görüşmede DSM-IV Eksen-I Bozuklukları için Yapılandırılmış Klinik Görüşme (SCID-I) kullanılarak katılımcılarda psikiyatrik bozukluk varlığı araştırmacılar tarafından değerlendirilmiştir. Her katılımcıya Hamilton Depresyon Derecelendirme Ölçeği (HAM-D) ve Hamilton Anksiyete Değerlendirme Ölçeği (HAM-D) uygulanmıştır. Ayrıca katılımcılara sorunla başa çıkma tutumlarını değerlendirmek için Başa Çıkma Tutumları Ölçeği (COPE) yapılmıştır. Bulgular: Zihinsel engelli çocuk annelerinin Hamilton Depresyon Derecelendirme Ölçeği’nden aldıkları puanların ortancası (en düşük-en yüksek) 6.0 (1-23), kontrol grubunun ise (en düşük- en büyük) 4.5 (0-19) olup aradaki fark istatistiksel olarak anlamlı bulunmuştur (p<0.05). Zihinsel engelli çocuk annelerinin Hamilton Anksiyete Değerlendirme Ölçeği’nden aldıkları puanların ortancası (en düşük -en büyük) 7.0 (2-41), kontrol grubunun ise 5.0 (0-16) olup istatistiksel olarak anlamlı derecede farklı bulunmuştur (p<0.05). Çalışmaya katılan anneler sorunla başa çıkma tutumlarına göre değerlendirildiklerinde, inkar ve davranışsal olarak boş vermeyi zihinsel engelli çocuk annelerinin, kontrol grubundaki annelere göre daha çok kullandıkları bulunmuştur. Sonuç: Aileler bu yoğun stresli, uzun süreli sorunla baş etmede çoğunlukla yetersiz kalmakta ve çeşitli davranışsal ve duygusal sorunlar yaşamaktadırlar. Bu nedenle ailelerin özelikle de çocuğa primer bakım veren annelerin desteklenmesi önemlidir.Objective: This study is planned in order to assess the depression, anxiety and stres coping strategies of the mothers whose children are mentally-disabled Material and Methods: 50 patients among the mothers of mentally-disabled children and 50 controls among the mothers of healthy children, were involved in the study. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was used to assess current psychiatric disorders. Hamilton Depression Rating Scale (HAM-D) and Hamilton Anxiety Rating Scale (HAM-D) were applied. Besides, Stress Coping Strategies Scale (COPE) was applied in order to assess the patients’ strategies of coping with problems. Results: The median score (minumum-maximum) which they got from Hamilton Depression Rating Scale is 6 (1-23) which is evaluated statistically-significant compared to the score of the control group of which score is 4.5 (0-19). The median score which the patients got from Hamilton Anxiety Rating Scale is 7.0 (2-41) which is evaluated statisticallysignificant compared to the score of control group of which score is 5.0 (0-16). It is found out that the patients involved in the study use denial and behavioral ignorance more than the control group when they are assessed according to their strategies of coping with problems. Conclusion: Families are mostly inadequate in the process of coping with this dense, stressful and long-term problem and they have some different behavioral and emotional problems. Therefore, it is important to support the families, especially the mothers who give primary care to the child

Severe mental disorders, depression and smoking cessation

In recent years, large campaigns have been organized for smoking cessation, health professionals have been educated about this topic and special treatment programs have been developed by the government for smokers. Although cigarette smoking is very frequent among patients with severe mental illness and it's a cause of morbidity and mortality, psychiatrists are not very eager for smoking cessation among psychiatric patients. However, in recent years, treatment studies have shown that with some modifications, conventional smoking cessation approaches may be quite beneficial among these severe mentally ill patients who are classically known to be failures in such treatments. In recent years, there have been developments in pharmacological approaches for smoking cessation, but neuropsychiatric side effects of these medications may be serious. Risk and benefit ratio for each patient should be taken into account while making a treatment plan

Characteristics of non-urgent visits in emergency department

Aim: In recent years, the number of patients using the emergency department is increasing and majority of these patients constitute non-emergency patients. In this study, it was aimed to examine the green field patients who applied to the emergency department of a tertiary hospital by non-urgent reasons and define the socio-demographic characteristics, the reasons for preferring the emergency department, to assess the rate of urgency defined by the participant, and to contribute to the literature by obtaining data for our country. Materials and Methods: This is a cross-sectional study in which the subjects were selected among the whole green area patients applied to emergency department in between 02 and 11 November 2018. Among these patients, the subjects who did not accept to be included to the study and didn’t fulfill the inclusion criteria were excluded. As a result, a total of 716 patients who accepted to be in the study and fulfilled the inclusion criteria were included to the study. Then, a questionnaire for the aim of assessing the socio- demographic characteristics and the reasons for preferring the emergency department, involving a scale to define the self-report of urgency were applied to those 716 volunteered patients. Results: In our study, 23.9 % of a total of 5644 patients applied to emergency department in between 02 and 11 November 2018 were grouped as non-urgent green area patients by the triage personnel. Of these green area patients those who accepted to be included to the study and fulfilled the inclusion criteria; 356 were female (49.7 %) and 360 were male (50.3 %). When the participants were evaluated according to their level of educations, 5.4 % were illiterate, 4.1 % were literate but had no school graduate, 30.6 % were primary education graduates and 13.4 % were university graduates. According to the reasons for choosing the emergency department, 48.2 % of the patients stated that they applied to the emergency department in need of emergency treatment, 22.5 % of the visitors declared that they were unable to get permission from their work in their working hours and 13.1 % of the visitors applied due to their opinion that things were progressing faster in the emergency department. In addition, the patients were asked to scale their urgency in a 10-point scale and the mean rate of urgency defined by the participants in the self-report scale was found to be 6 points (0-10) and negative correlation was observed between education levels and urgent levels. Conclusion: In this study, we obtained descriptive data about the green field patients who applied to the emergency department by non-urgent reasons, defined their socio-demographic characteristics, revealed the reasons for non-urgent applications to the emergency department, and assessed the self-rate of urgency defined by the participants. Since it can be predicted that the overcrowding generated by these non-urgent visits has negative effects and consequence on patients and employees; we consider that this study and similar studies may be helpful in describing the current problem, may help to solve the problem by contributing to the literature