Body Dysmorphic Disorder

Body dysmorphic disorder is a type of mental illness, wherein the affected person is concerned with body image, manifested as excessive concern about and preoccupation with a perceived defect of their physical features. Although it is a common disease and has been defined in the literature over a century, it is not a well known disease. Chronic, treatment resistant and sometimes delusional nature could result in severe functional impairment. The diagnosis and appropriate therapy of disorder are crucial because of increased suicidality and reduction in life quality. In this article the symptoms, etiology, clinical features and treatment of body dysmorphic disorder are briefly reviewed

Treatment Adherence in Psychiatric Disorders

Despite developments in treatment options there is no significant increase in treatment adherence ratios. Inadherence in psychiatric disorders is higher than the other diseases. Loss of insight, drugs' side effects, sociodemographic features, personality traits are major factors affecting the treatment adherence. Determining and overcoming these factors for each disorder will help to improve adherence and reduce the treatment costs and hospitalization. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(1): 85-93

COVID-19 Pandemic: A comparison of adult and pediatric populations

Aim:  Couple of pneumonia cases were reported in a short period in Wuhan, China. The cases were revealed to be associated with a different coronavirus type was named SARS-CoV-2 and the disease was identified as Covid-19.  It is known that the disease occurs in all age groups. We aimed to evaluate the differences in clinical and laboratory features between adult and pediatric patients. Method: The study is a retrospective cross-sectional study and consists of 206 patients with a definitive diagnosis of Covid-19 confirmed by a positive real-time reverse-transcriptase polymerase chain reaction (RT-PCR) testing for SARS-CoV-2. They hospitalized in health institutions connected to City Health Administrative of Bolu, Turkey between 11.03.2020 and 19.04.2020. The number of the pediatric patients (0-17 age group) was 106, that of the adult patients (18 and above age group) was 100. Data concerning the patients consisted of age, symptoms, laboratory parameters such as hemogram, biochemistry, coagulation. Results: The mean values of platelet (PLT), platocrit (PCT), percentage of monocytes (MONO %) and MONO in the “0-17” age group were found to be significantly higher than the mean values in the “18 and above” age group. The hemoglobin (HGB) mean value of the “0-17” age group was significantly lower than that of the “18 and above” age group. The mean C - reactive protein (CRP) value of the “0-17” age group (4.55; min: 1.20 – max: 11.80) was significantly lower than that of the “18 and above” age group (5.35; min 1.25- max: 19.77) with no statistically significance. In pediatric group, the most common symptoms were other symptoms like diarrhea, vomiting and joint pain whereas the adult patients had fever and cough often with statistically significant. Conclusion: Clinical findings and laboratory abnormalities in Covid-19 are less common in children. Although it seems that Covid-19 is less symptomatic in children, they are also affected by the disease. Performing RT-PCR test based on the contact history of the children may help to minimize morbidity with an early diagnosis. Multicenter studies with more numbers of patients should be performed

Effects of Parental Divorcement on Impulsivity in Adolescence

Objective: The impact of parental coexistence on overcoming the adolescence period is being discussed. The aim of this study is to examine if there is a statistically signi-ficant difference in the level of impulse control among the adolescent children of married and divorced couples and to investigate the effect of the socio-demographic characteristics of the divorce process on impulsivity of adolescents. Method: Fifty girls and 50 boys ages of 12-17 with divorced parents, 50 boys and 50 girls with undivorced parents were included in the study. This is a cross-sectional study. The impulse control levels of adolescents were compared with the Barrat Impulsiveness Scale (BIS). The effect of the educational status of the parents, the gender and the age of the adolescent, the parent with whom the adolescent live, time after divorce process on the level of impulse control were examined. The value of p<0.05 was considered as statistically significant. Results: There were no statistically significant differences between groups in total BIS scores and all subscale scores (p=0,743). In the divorced families, statistically significant difference was found between the time after the divorce and the BIS scores (P=0,002), while there was no statistically significant difference between the education levels of the parents, the parent with whom the adolescent live and the gender of adolescent. Discussion: According to this study, divorce did not effect the impulse control levels of adolescents between 12-17 years. Adolescents aged 6 years or younger in the divorce process were thought to have more impulse control problems than olders. It was thought that evaluation of divorcement and different factors would give better results in studies about impulsivity in adolescence

Tardive Dyskinesia and Treatment Approaches

Tardive dyskinesia is an iatrogenic movement disorder with an incompletely determined etiology. Involuntary movements can effect oral, lingual, facial, corporal muscles and can be permanent. Tardive dyskinesia is one of the most important side effects of long term antipsychotic use. There is some decrease in tardive dyskinesia rates after common use of second generation antipsychotics but tardive dyskinesia can be seen even after use of second generation antipsychotics. There are some treatment options from drug-free observation to deep brain stimulation in tardive dyskinesia. The aim of this article is to review epidemiology, etiology, risk factors, pathophysiology and treatment options of tardive dyskinesia

Relationship Between Adult Separation Anxiety Disorder and Suicide in Patients with Bipolar Disorder

Life expectancy of patients with bipolar disorder (BD) is known to be shorter than the general population. Some of the premature deaths in these patients are attributed to unnatural causes such as suicide, accidents and homicides. Death due to suicide is 15 times more common in patients with GI compared to the general population. The present study aimed to investigate the comorbidity of Adult Separation Anxiety Disorder (ASAD) and the relationship between this comorbidity and suicide in patients with BD. A total of 138 outpatients with BD at remission between the ages of 18-65 years and 63 healthy controls were included in our study. All participants were administered a sociodemographic data form, Hamilton Depression Scale (HMDS), Young Mania Rating Scale (YMRS), Adult Separation Anxiety Questionnaire, and Structured Clinical Interview for Separation Anxiety Symptoms (ASAD-SCI). The age and gender of the participants did not differ significantly between the control group, the BD and BD+ASAD groups. The mean age of the participants was 42.3±11.9 years. When categorized according to gender, 42.3% of the participants were male and 57.7% were female. ASAD was detected in 46.3% of the participants. The suicide attempt rate was significantly higher in the BD and BD+ASAD groups than in the control group. The rate of suicide attempt was significantly higher in the BD+ASAD group than in the BB group. We demonstrated that the comorbidity of ASAD was associated with previous suicide attempts in patients with BD. Recognizing and treating ASAD in patients with BD may reduce suicide attempts in these patients

Adherence to the Treatment and Outpatient Appointments in Psychiatric Patients.

TEZ9705Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2015.Kaynakça (s. 51-54) var.vii, 59 s. : tablo ; 29 cm.Amaç: Çukurova Üniversitesi Tıp Fakültesi Balcalı Hastanesi Psikiyatri Kliniği?nde 2011 yılında yatarak sağaltım gören hastaların taburculuk sonrası poliklinik kontrollerine ve önerilen ilaçların kullanımına uyum sağlayıp sağlamadığını saptamaktır. Yöntem: Çalışmaya alınan hastaların öncelikle klinik dosyaları incelendi. Tarafımızca oluşturulan sosyodemografik veri formunda öncelikle hastaların DSM-IV TR?ye göre 1. Eksen tanıları ve ilgili diğer bölümler dolduruldu. Klinik dosyaların incelenmesi tamamlandıktan sonra hastaların poliklinik dosyaları incelendi. Morisky Uyum Ölçeği esas alınarak tarafımızca oluşturulan uyum ölçeği gereğince hastaların taburculuk sonrası 1. ve 3. aylarda poliklinik kontrollerine gelip gelmediği ve hekim tarafından önerilen ilaçları kullanıp kullanmadığı retrospektif olarak taranarak uyum ölçeğinde ilgili bölümler dolduruldu. Bulgular: Çalışmaya katılan 230 hastanın klinik ve poliklinik dosyalarının incelenmesi sonucunda uyuma etki eden faktörlerin; hastanın DSM- IV?e göre 1. Eksen ve 2. Eksen tanısının varlığı, günlük kullanılan ilaç sayısı, eşlik eden tıbbi hastalıklar, ailede ruhsal hastalık öyküsü, içgörü varlığı gibi çeşitli nedenler olduğu saptandı. Sonuç: Bu çalışmaya göre hastalık tanısına göre değişen oranlarda (% 16.7- % 68.8) uyumsuzluk saptanmıştır. Tıpta ve ilaç sanayisindeki gelişmelere rağmen geçmiş yıllara göre tedavi uyumunda bir artış sağlanamamıştır. Olası çözümlerin bulunabilmesi için; uyumsuzluğa neden olan etkenlerin klinik pratikte sorgulanması ve eğer uyumsuzluk varsa bu konu üzerinde önemle durulması gerekmektedir.Aim: The aim of this study was to determine the adherence with treatment and outpatient appointments among patients who had been hospitalized in inpatient clinic of Department of Psychiatry of Cukurova University Faculty of Medicine in 2011. Material and Method: Clinical records of patients were analyzed initially. Axis I psychiatric disorders of patients which were diagnosed by using DSM-IV-TR criteria and associated characteristics of disorders were completed in the socio-demographic data form. According to our retrospective adherence scale which was based on Morisky Adherence Scale, patients? adherence to the appointments at the first and third months after discharging from hospital and taking their medication as recommended were checked. Findings: According to the current study, the reasons have effects on the patients? adherence were Axis I and Axis II psychiatric disorders according to DSM-IV, number of daily medications taken, presence of comorbid medical illnesses, family history of psychiatric illnesses and presence of insight. Conclusion: The results of this study have shown that the rate of non-adherence with treatment changes between 16.7 % -68.8 % according to disorder. Although medical treatments and drug industry develop day by day, there have been no changes in the treatment adherence ratios in the past years. To generate possible solutions, treatment adherence should be assessed in all clinical interviews and if patient is non-adherent this issue should be handled seriously

Dependence in the Elderly

Yaşlı bireylerde madde kullanımı ile ilişkili bozukluklar, son yıllarda dikkat çeken sorunlardan biri olarak göze çarpmaktadır. Madde kullanımı ile ilgili 2015 yılında yapılan bir çalışmada hastaneye madde kullanımı ile ilişkili bozukluklar nedeniyle tedavi amaçlı başvuran yaklaşık 1,500,000 hastanın %17.3’ünü 50 yaş ve üzeri bireylerin oluşturduğu saptanmıştır. Özellikle yaşlı bireylerde bir çok kronik hastalığın bir arada olması, çoklu ilaç kullanımı, böbrek ve karaciğer fonksiyonlarında değişiklik gibi bir çok neden madde kullanımının zararlı etkilerini önemli ölçüde arttırmakta ve sorunu çok daha karmaşık bir hale getirmektedir. Genç bireylerde madde ile ilişkili bozuklukları saptamak için bir çok tarama testi olmasına rağmen, aynı testlerin bir çoğu yaşlı bireyler için valide değildir. Alkol, şu an için en çok kullanılan madde olmakla birlikte, benzodiazepin, opiat grubu ilaçlar, marihuana kullanımı da gün geçtikçe artmaktadır. Yaşlı bireylerde sorunun saptanması kadar tedavi de önemli bir konudur ve dikkatle değerlendirilmesi gerekmektedir. Bir çalışmada yaşlı bireylerde madde kullanımına bağlı tedavinin %250 oranında artarak 2020 yılında 4.4 milyon kişiyi etkileyeceği öngörülmüştür. Dolayısıyla yaşlı bireylerde madde ile ilişkili bozukluklar detaylı bir şekilde irdelenmelidir ve bu konu ile ilgili yeni araştırmalara ihtiyaç vardır

Terminal lucidity phenomena

Psikiyatrik ve nörolojik hastalıklarda, hastalığın genel seyrinin aksine ölümden kısa süre önce zihin açıklığı yaşanması, hastalık semptomlarının iyileşme göstermesi son 250 yıldır literatürde yer almasına rağmen yeteri kadar ilgi görmemiştir. İngilizce kaynaklarda 'terminal lucidity' olarak yer alan bu fenomen Türkçe'ye ölüm iyiliği olarak çevrilebilir. Ölüm iyiliği fenomeni; demans, şizofreni, beyin absesi, bozukluklarında görülebilir. Bu fenomenin sebeplerinin, nörobiyolojisinin açıklığa kavuşturulması, bahsedilen hastalıklar için yeni tedavi yöntemlerinin geliştirilmesine ve ölümden önceki son zamanların hastalar ve hasta yakınları açısından daha mutlu geçirilmesine katkıda bulunacaktırUnexpected symptom remission in psychiatric and neurologic disesases shortly before patients' death have been known since last 250 years but not received enough attention. This phenomenon is called terminal lucidity. Terminal lucidity can be experienced at patients with diagnosis of dementia, schizophrenia, brain abscess, brain tumour, stroke and mood disorders. Explanatory models about reasons and neurobiology of this phenomenon will contribute to develop new treatment strategies about mentioned diseases and to live last moments times before death bette

Clozapine induced enuresis treated with Amitriptyline: A case report

WOS: 000435639400017Tardive dyskinesia is characterized by involuntary movements which appear in connection with long-term blockage of dopamine 2 receptors following the use of antipsychotics. One of the treatment options in cases of tardive dyskinesia which occasionally induced by aripiprazole is clozapine. Clozapine is distinguished from other antipsychotics by its effective strength because of its unique receptor profile and its side effects. Clozapine may cause enuresis by various mechanisms. Among the pharmacological choices for the treatment of clozapine-related enuresis are desmopressin, oxybutynin, trihexyphenidyl, amitriptyline, aripiprazole, ephedrine, and verapamil. The patient's psychiatric diagnosis determines the choice of medication with their possible side effects