Psychotic disorder secondary to systemic corticosteroids

1949 yılında kortikosteroidlerin keşfi tıp pratiğinde bir devrim olmuştur. Kortikosteroidler; çeşitli akut ve kronik hastalıkların (örneğin, endokrinopati, kanser, inflamatuar hastalıklar, sistemik lupus eritematozus, multipl skleroz ve astım) tedavisinde önemli bir yer tutmaktadır. Kortikosteroidlerin tıp alanında kullanılmasından sonra çeşitli bedensel ve nöropsikiyatrik yan etkileri olduğu anlaşılmıştır. Kortikosteroidler, nöropsikiyatrik yan etki olarak genellikle depresyon, mani, psikoz, deliryum, obsesif-kompulsif belirtiler, intihar, katatoni ve tersinir bunama tablolarına neden olur. Biz olgumuzda 67 yaşında sistemik kortikosteroid tedavisi aldıktan sonra psikotik tablo geliştiren bir erkek hastayı tartıştık. (Anadolu Psikiyatri Derg 2016; 17(1):74-76)The discovery of corticosteroids in 1949, revolutionized the practise of medicine. Corticosteroids become the mainstay of therapy for a variety of acute and chronic diseases (e.g., endocrinopathies, cancer, inflammatory diseases, systemical lupus erythematosus, multiple sklerosis, and asthma). Corticosteroids often induce psychiatric syndromes, including depression, mania, psychosis, delirium, obsessive-compulsive symptoms, suicidality, catatonia and reversible dementia1. In our case, we will discuss 67 years old male patient who developed psychotic disorder after receiving systemic corticosteroid treatment. (Anatolian Journal of Psychiatry 2016; 17(1):74-76

Relationship of levetiracetam and obsessive-compulsive disorder: a case report

Levetiracetam has gained wide acceptance in the treatment of epilepsy due to its broad-spectrum efficacy, the lack of significant drug–drug interactions, and a relatively benign side effect profile. However, in recent years, the treatment of epilepsy using levetiracetam has been associated with psychiatric side effects such as anxiety, irritability, hostility, depression, hallucinations, and, in some rare cases, obsessive-compulsive disorder. In this case report, we present and discuss onset of obsessive-compulsive disorder symptoms in a 55-year-old epileptic female patient, who did not have any previous psychiatric disorder, including obsessive-compulsive disorder, and who received levetiracetam treatment

Quickly diagnosed and treated prepubertal Type 1 narcolepsy case

Excessive daytime sleepiness, cataplexy, sleep paralysis, and hypnagogic hallucination are the classic tetrad of narcolepsy. It has been shown that narcolepsy, a chronic and disabling disease, starts in childhood and adolescence rather than adulthood. The International Classification of Sleep Disorder (ICSD-3) classifies narcolepsy into Type 1 (narcolepsy with cataplexy) and Type 2 (narcolepsy without cataplexy). There is low awareness and knowledge of narcolepsy among the general public, primary care physicians, and sleep specialists. It has been shown that the lack of recognition of disease symptoms delayed the diagnosis of narcolepsy from 8.7 to 22.1 years. In this case report, we will discuss the case of Type 1 narcolepsy, which started in the prepubertal period and was diagnosed and treated in a short period of time

Quality of Life and Associated Risk Factors in Caregivers of Patients with Obsessive Compulsive Disorder

INTRODUCTION: Obsessive compulsive disorder (OCD) is a chronic disease that affects social relationships, and occupational and academic performance of patients and their relatives due to cognitive, emotional, and behavioural aspects of the disease. Quality of life (QoL) in relatives of patients with OCD has previously been reported and compared with caregivers of patients with other psychiatric conditions. However, there are few studies available in the literature regarding the causality of QoL in caregivers of patients with OCD. OBJECTIVE: The aim of this study was to evaluate QoL of caregivers of patients with OCD and predictors of QoL of the family caregivers. METHODS: The study population comprised of 68 patients with OCD and their caregivers. The dependent variable of this study is “QoL of caregivers” as assessed by the short version of the World Health Organization Quality of Life questionnaire (WHOQOL-BREF-TR). The Structured Clinical Interview for DSM-IV/Clinical Version (SCID-I/CV), Yale-Brown obsessive-compulsive scale (Y-BOCS), Y-BOCS symptom checklist, Hamilton Depression Rating Scale (HAM-D), and WHOQOL-BREF-TR were completed by the patients, whereas the SCID-I/CV, WHOQOL-BREF-TR, and Burden Assessment Scale (BAS) were completed by the caregivers. Student’s t-test, MWU, ANOVA, Kruskal–Wallis ANOVA, and Spearman’s correlations were used in univariate analyses, and multiple linear regression tests were run in multivariate analyses. Critical VIF values were taken as 5.0 for detecting collinearity among independent variables in the regression analyses. Type 1 error was taken as 0.05 in the analyses. RESULTS: Linear regression analysis showed that caregivers’ sex, education level, occupational status, disease burden, and patients’ sex, physical QoL, and disease severity were predictors of caregivers’ QoL. Moreover, disease burden was the only common predictor that affected all four dimensions (physical, psychological, social relations, environmental) of the caregiver’s QoL, and as the perceived disease burden increased, the caregiver’s QoL deteriorated

Health professionals exposure to mobbing in a medical school hospital

Aim: This study was conducted to reveal the perceptions of the residents and nurses working in their workplace. Material and Methods: This study is a cross-sectional descriptive study. the study was carried out between October 2014 and January 2016. the study population consisted of the residents and nurses working in Manisa Celal Bayar University, Hafsa Sultan Hospital. the study sample included 110 people. the survey was performed using a questionnaire consisting of an Information Form and the Work Harassment Scale. Results: the employees’ mean age was 29.92±5.47; 73.6% of them were female and 59.1% married; 46.4% had bachelor’s degree; 61.8% had balanced income and expenses; 32.7% were residents and 60.9% nurses/midwives; and 26.4% were victims of mobbing. Some 13.6% of those who were subject to mobbing stated that they were exposed to mobbing for 6 to 11 months. Approximately 42.7% of the health professionals stated that they witnessed others being subject to mobbing. Some 24.5% of the health professionals expressed their need for psychological support. Conclusion: the study showed that those with high level of education, those in the younger adult group (22-30 years of age) and those who needed psychological support were at a higher risk of being exposed to mobbing, the difference being statistically significant (p<0.05). To reduce the level of mobbing and provide quality healthcare services in hospitals, arrangements should be made to increase the number of nurses/midwives and doctors at work, and to educate employees on subjects related to communication and mobbing by psychiatric nurses

Evaluation of serum MicroRNA expression profiles in patients with panic disorder

BACKGROUND: Studies on the role of microRNAs (miRNA) in anxiety disorders are limited. We aimed to determine the availability of miRNAs as biomarkers in serum and to demonstrate the changes of miRNAs expression in patients with panic disorder (PD). METHODS: Thirty-five patients with PD and 35 healthy controls (HC) were evaluated with Structured Clinical Interview for DSM Disorders-I (SCID-I) and Panic Disorder Severity Scale (PDSS). In each group miRNA expression analysis was performed in venous blood by the Real-time Polymerase Chain Reaction (RT–PCR) method for genetic evaluation. RESULTS: Compared with the HC group, eight miRNA expression levels were found different in the PD group. Five of them were upregulated and three of them were downregulated. There was no correlation between the levels of miRNA expression with PDSS total score and PDSS sub-items. However, miR-1297 and miR-4465 expression levels were significantly different between the two groups. LIMITATIONS: There are some limitations in this research. Firstly the number of samples is small. Another limitation of our study is that the presence of medical illness and continuous drug use were not excluded when PD and HC groups were selected. CONCLUSIONS: Our research is the first miRNA expression study in patients with PD which excluded psychotropic use and additional psychiatric disorders. In the PD group, miR-1297 and miR-4465 expression was upregulated than compared to the HC group. miR-1297 and miR-4465 regulate the GABAA gene regions that affect GABAA receptor subtypes that thought to play a role in the aetiology of PD