Epidemiologic Assessment of Mortality among Inpatients in a Psychiatric Hospital

Individuals with psychiatric disorders have higher early mortality rates than the general population, and all types of mental disorders are associated with a short life expectancy. In this context, assessment of the mortali-ties of both natural and unnatural causes in psychiatric inpatients is of critical importance in terms of mortality epidemiology, which provides data that can help improve the quality and planning of psychiatric care. The popu-lation of this study retrospective, cross-sectional study consisted of inpatients that died in Manisa Mental Health and Diseases Hospital between May 2002 and December 2022. Of the 120 inpatients that died, 119 patients, 63.9% male, and 36.1% female, were included in the study sample. The mortality rate decreased from 3.2% to 0.22% during the period covered by the study. The difference between mortality rates before 2013, when qua-lity and accreditation processes started, and after 2013 has decreased from 74.8% to 25.2%. Of the natural deaths, 45.4% were caused by cardiac arrest, whereas 100% of the unnatural deaths occurred due to suicides. Short hospital stays and close follow-up in the first week of hospitalization are essential in reducing mortality rates in psychiatric inpatients. In addition, increasing the quality of health care in accordance with the national and international quality and accreditation criteria will further reduce the mortality rates in psychiatric inpati-ents

6284 Sayılı Ailenin Korunması ve Kadına Karşı Şiddetin Önlenmesine İlişkin Yasanın Sağlık Tedbiri Uygulamaları: Psikiyatri Hastanesi Örneği

<p><strong>Amaç</strong>: 6284 sayılı Kanun'un m 5 hükmünün ilk fıkrasının (ı) bendi uyarınca; "şiddet uygulayanın bir sağlık kuruluşuna muayene veya tedavi için başvurması ve tedavisinin sağlanması" hususunda tedbir kararı verilmesi mümkündür. Şiddet uygulayanın muayene ve tedavisi hususunda tedbir kararı verilebilmesi için söz konusu kişinin şiddet uygulamış olmasının yanı sıra, şiddet teşkil eden davranışların kişinin tedavi edilmesi suretiyle ortadan kalkabilecek bir etkenden kaynaklanması gerekir. Bu çalışmanın amacı, mahkemelerce verilen sağlık tedbiri kararları doğrultusunda Manisa İl Sağlık Müdürlüğü Ruh Sağlığı ve Hastalıkları Hastanesince gerçekleştirilen çalışmaların değerlendirilmesidir.</p><p><strong>Gereç ve Yöntem:</strong> Araştırma retrospektif nitelikte bir araştırmadır. Çalışmanın evrenini Manisa Ruh Sağlığı ve Hastalıkları Hastanesinde 6284 yasa gereği Sağlık Tedbiri Kararları doğrultusunda mahkemece karar verilen başvurusu olan tüm bireyler oluşturmuştur. 2022-2023 yılında kayıtlı dosyalar araştırmacılar tarafından geriye dönük olarak incelendi. Araştırmanın örneklemini 60 birey dosyası oluşturmuştur. İstatistiksel analizde sayı yüzde testi kullanıldı. </p><p><strong>Bulgular</strong>: Bireylerin %73.3'i erkek, %26.7'si kadın,  %33.3'sı bekar, %20.0'ı evli, %6.7'si eğitim durumu ortaokul, %6.7'nin eğitim durumu lise, %15.0'ı çalışmadığı belirlendi. Bireylerin %18.8'i psikolojik şiddet, %31.3'ü psikolojik şiddet ve fiziksel şiddet, %50.0'i fiziksel şiddet uyguladığı belirlendi. Bireylerin şiddet uyguladığı kişi olarak en çok (%37.5) eşine, %21.9'u ailesine, %18.8'i annesine şiddet uyguladığı belirlendi. Bireylere bu doğrultuda durumuna göre yatarak tedavi yada polikinik takibi önerilmiştir. </p><p><strong>Sonuç: </strong>Bu araştırmada, sağlık tedbiri uygulamasının öneminin ve gerekliliğinin daha iyi anlaşılması ile kayıt ve takip sisteminin geliştirilmesinin etkili olduğu düşünülmektedir.</p&gt

Mescaline abuse via peyote cactus: the first case report in Turkey

WOS: 000391568700020Mescaline is a psychoactive hallucinogenic alkaloid that resemble the natural neurotransmitters epinephrine and dopamine. It is extracted from peyote cactus. Peyote cactus cannot be detected via blood or urine samples in routine toxicology laboratories, and it can be easily reachable over the Internet. In this report, we presented the first case of mescaline abuse via peyote cactus in Turkey. The case is an 18-year-old male patient. He was subjected to probation service due to use of cannabis for three months by the court decision, and being treated in our forensic outpatient clinic. He was admitted to the emergency service with symptoms such as intense anxiety, panic attacks and visual hallucinations. Patient told that he consumed peyote cactus instead using cannabis not to get caught in urine analyze

Mescaline abuse via peyote cactus: the first case report in Turkey

Meskalin, doğal nörotransmitter olan epinefrin ve dopamine benzer bir psikoaktif halüsinojenik alkaloiddir. Meskalin, peyote kaktüsünden elde edilir. Peyote kaktüsü rutin toksikoloji laboratuvarlarında kan veya idrar örneklerinde saptanamaz ve internet üzerinden kolayca sağlanabilir. Bu olgu sunumunda, Türkiye'de peyote kaktüsü yoluyla meskalin kötüye kullanan ilk olgu sunulmuştur. On sekiz yaşında bir erkek hasta, üç aydır esrar kullanması nedeniyle mahkeme kararı ile denetimli serbestlik hizmeti alması için hastanemize gönderilmişti ve adli psikiyatri polikliniğimizde tedavi edilmekte idi. Acil servisimize yoğun anksiyete, panik atak ve görsel varsanılar gibi belirtilerle başvurdu. Hasta, idrar tetkikinde esrar kullandığının anlaşılmaması için peyote kaktüsü kullandığını belirtti. (Anadolu Psikiyatri Derg 2016; 17(Ek.3):68-70).Mescaline is a psychoactive hallucinogenic alkaloid that resemble the natural neurotransmitters epinephrine and dopamine. It is extracted from peyote cactus. Peyote cactus cannot be detected via blood or urine samples in routine toxicology laboratories, and it can be easily reachable over the Internet. In this report, we presented the first case of mescaline abuse via peyote cactus in Turkey. The case is an 18-year-old male patient. He was subjected to probation service due to use of cannabis for three months by the court decision, and being treated in our forensic outpatient clinic. He was admitted to the emergency service with symptoms such as intense anxiety, panic attacks and visual hallucinations. Patient told that he consumed peyote cactus instead using cannabis not to get caught in urine analyze. (Anatolian Journal of Psychiatry 2016; 17(Suppl.3):68-70)

Psikiyatri polikliniğine başvuran hastalarda geleneksel ve tamamlayıcı tıp uygulamalarının özellikleri ve yaygınlığı

Purpose: The aim of this study was to determine the variables in the use of traditional and complementary medicine for psychiatric complaints in and around the city of Adana, in Turkey’s Eastern Mediterranean region. Material and Methods: The study was performed with 1768 psychiatric outpatients of Çukurova, Kozan and Ceyhan State Hospitals in Adana who gave written approval and fitted the criteria. The structured clinical interview for DSM-5 was performed by a psychiatrist, and a questionnaire was given to gather socio-demographic information and clinical details on the use of traditional and complementary medicine. Results: The proportion of participants using some kind of traditional and complementary medicine was found to be 39.7%. Those mostly used were, in order of frequency, prayer and consultation (16%), herbal products (10.5%), and nutritional supplements (7.1%). Regarding the perceived effectiveness of the use of traditional and complementary medicine, 68.6% of participants reported that they were partially or greatly effective. The use of traditional and complementary medicine was greater among the elderly, those living in rural areas, those with a low income, and those with a low education level. Conclusion: The results of our study show that the use of traditional and complementary medicine among the mentally ill is widespread, and it is important that physicians and policy-makers should be aware this fact.Amaç: Bu çalışmanın amacı, Türkiye’nin Doğu Akdeniz Bölgesindeki Adana ili ve çevresinde, psikiyatrik yakınmalarda geleneksel ve tamamlayıcı tıp kullanımındaki değişkenleri belirlemektir. Gereç ve Yöntem: Bu çalışma, Adana ilindeki Çukurova, Kozan ve Ceyhan Devlet Hastaneleri psikiyatri polikliniklerine ayaktan başvuran, katılma ölçütlerini karşılayan ve yazılı onam veren 1768 hasta ile yürütülmüştür. DSM-5 için yapılandırılmış klinik görüşme psikiyatrist tarafından yapılmıştır. Sosyodemografik bilgiler ile geleneksel ve tamamlayıcı tıp uygulamalarındaki klinik ayrıntıların toplanılması için bir anket formu verilmiştir. Bulgular: Herhangi bir geleneksel ve tamamlayıcı tıp uygulamasına başvuran katılımcı oranı %39.7 idi. En çok kullanılanlar, sıklık sırasına göre; dua ve danışma (%16), bitkisel ürünler (%10.5) ve besin ekleriydi (%7.1). Geleneksel ve tamamlayıcı tıp uygulamasının algılanan etkinliği açısından bakıldığında, katılımcıların %68.6’sı kısmen ya da büyük oranda etkili bulduğunu bildirmiştir. Verilerimize göre yaşlılarda, kırsal kesimde yaşayanlarda, düşük gelir grubunda ve düşük eğitim düzeyinde geleneksel ve tamamlayıcı tıp kullanımı daha fazladır. Sonuç: Çalışmamız, rusal hastalığı olanlarda geleneksel ve tamamlayıcı tıp kullanımının yaygın olduğunu göstermiştir. Hekimlerin ve politika belirleyicilerin bu durumun bilincinde olmaları önem taşımaktadır

Prevalence and characteristics of traditional and complementary medicine utilization in an outpatient psychiatric population

Amaç: Bu çalışmanın amacı, Türkiye'nin Doğu Akdeniz Bölgesindeki Adana ili ve çevresinde, psikiyatrik yakınmalarda geleneksel ve tamamlayıcı tıp kullanımındaki değişkenleri belirlemektir. Gereç ve Yöntem: Bu çalışma, Adana ilindeki Çukurova, Kozan ve Ceyhan Devlet Hastaneleri psikiyatri polikliniklerine ayaktan başvuran, katılma ölçütlerini karşılayan ve yazılı onam veren 1768 hasta ile yürütülmüştür. DSM-5 için yapılandırılmış klinik görüşme psikiyatrist tarafından yapılmıştır. Sosyodemografik bilgiler ile geleneksel ve tamamlayıcı tıp uygulamalarındaki klinik ayrıntıların toplanılması için bir anket formu verilmiştir. Bulgular: Herhangi bir geleneksel ve tamamlayıcı tıp uygulamasına başvuran katılımcı oranı %39.7 idi. En çok kullanılanlar, sıklık sırasına göre; dua ve danışma (%16), bitkisel ürünler (%10.5) ve besin ekleriydi (%7.1). Geleneksel ve tamamlayıcı tıp uygulamasının algılanan etkinliği açısından bakıldığında, katılımcıların %68.6'sı kısmen ya da büyük oranda etkili bulduğunu bildirmiştir. Verilerimize göre yaşlılarda, kırsal kesimde yaşayanlarda, düşük gelir grubunda ve düşük eğitim düzeyinde geleneksel ve tamamlayıcı tıp kullanımı daha fazladır. Sonuç: Çalışmamız, rusal hastalığı olanlarda geleneksel ve tamamlayıcı tıp kullanımının yaygın olduğunu göstermiştir. Hekimlerin ve politika belirleyicilerin bu durumun bilincinde olmaları önem taşımaktadır.Purpose: The aim of this study was to determine the variables in the use of traditional and complementary medicine for psychiatric complaints in and around the city of Adana, in Turkey's Eastern Mediterranean region. Material and Methods: The study was performed with 1768 psychiatric outpatients of Çukurova, Kozan and Ceyhan State Hospitals in Adana who gave written approval and fitted the criteria. The structured clinical interview for DSM-5 was performed by a psychiatrist, and a questionnaire was given to gather socio-demographic information and clinical details on the use of traditional and complementary medicine. Results: The proportion of participants using some kind of traditional and complementary medicine was found to be 39.7%. Those mostly used were, in order of frequency, prayer and consultation (16%), herbal products (10.5%), and nutritional supplements (7.1%). Regarding the perceived effectiveness of the use of traditional and complementary medicine, 68.6% of participants reported that they were partially or greatly effective. The use of traditional and complementary medicine was greater among the elderly, those living in rural areas, those with a low income, and those with a low education level. Conclusion: The results of our study show that the use of traditional and complementary medicine among the mentally ill is widespread, and it is important that physicians and policy-makers should be aware this fact

Investigation of miRNA and cytokine expressions in latent tuberculosis infection and active tuberculosis

Background/aim: In tuberculsosis (TB), miRNA has been used as a biomarker to distinguish between healthy individuals and TB patients. The aim of this study was to investigate (i) the association of the miRNA and cytokine expression levels, the course of tuberculosis infection, clinical forms and response to treatment, and (ii) the effects of genotypic features of bacteria on the course of tuberculosis and the relationship between miRNA and cytokine expressions and bacterial genotypes. Materials and methods: A total of 200 cases (100: culture positive active tuberculosis, 50: quantiferon positive latent tuberculosis infection and 50: quantiferon negative healthy controls) were included in the study. For the tuberculosis group at the time of admission and after treatment, for the latent tuberculosis infection and healthy control groups at the time of admission, miRNA and cytokine expressions were determined. Genotyping of M.tuberculosis isolates was performed by spoligotyping method. Results: While, in the comparison of miRNA expressions between the pretreatment patient group and the healthy control group, there was a statistically significant decrease in the expression of miR-454-3p, miR-15a-5p, miR-590-5p, miR-381, and miR-449a in the Pulmonary TB group, there was no significant change in miRNA expression in extrapulmonary TB patients. When the cytokine expressions of the patient group and the healthy control group were compared before treatment, the expressions of all cytokines in the patient group decreased. However, the only cytokine that showed a significantly lower expression was IL12A in PTB patients. Conclusion: There is no significant relationship between the clinical course of the disease, cytokine and miRNA expression, and the genotype of the bacteria.Scientific and Technological Research Council of Turkey (TUBITAK) [115S333]This study was supported by grant 115S333 by the Scientific and Technological Research Council of Turkey (TUBITAK)

Alterations in BDNF (brain derived neurotrophic factor) and GDNF (glial cell line-derived neurotrophic factor) serum levels in bipolar disorder: The role of lithium

Objective: Brain-derived neurotrophic factor (BDNF) has been consistently reported to be decreased in mania or depression in bipolar disorders. Evidence suggests that Glial cell line-derived neurotrophic factor (GDNF) has a role in the pathogenesis of mood disorders. Whether GDNF and BDNF act in the same way across different episodes in bipolar disorders is unclear

Efficacy and Safety of Paliperidone Palmitate Treatment in Patients With Schizophrenia A Real-World Multicenter, Retrospective, Mirror-Image Study

Purpose The aim of the study was to assess efficacy and safety of paliperidone palmitate (PP) in schizophrenic patients using real-life data. Methods This national, multicenter, retrospective, and mirror-image study was performed reviewing the medical records of patients in 18 centers. Adult schizophrenic patients receiving PP treatment (n = 205) were enrolled. Patients' data covering the last 12 months before the initial PP injection and the period until the end of study with at least 12 months after the initial PP injection were evaluated. Patients' characteristics, scale scores, and adverse events were recorded. Results Nonadherence to prior medication was the most frequent reason for switching to PP treatment. Comparing with the period before PP treatment, the rate of patients visiting the hospital for relapse (79.5% vs 28.9%, P < 0.001) and the median number of hospitalizations (2 vs 0, P < 0.001) were lower during PP treatment. During PP treatment, the Positive and Negative Syndrome Scale score decreased by 20% or more (response to treatment) in 75.7% of the patients. The frequency of adverse events did not differ between the period before and during PP treatment. Improvement in functionality was higher in those with disease duration of 5 years or less. Conclusions Paliperidone palmitate is effective and safe in treatment of schizophrenic patients and in switching to PP treatment in patients with schizophrenia, which reduced the percentage of patients admitted to the hospital for relapse and the median number hospitalization, and has positive effects on functionality