DETERMINING THE RISK OF CARDIOVASCULAR DISEASE IN PATIENTS DIAGNOSED WITH SCHIZOPHRENIA AND BIPOLAR AFFECTIVE DISORDER

Background: In Schizophrenia (SCZ) and Bipolar Affective Disorder (BAD) patients using the Framingham Heart Risk Scoring (FHRS), we aimed to investigate the possible cardiac arrhythmia risk by calculating electrocardiogram (ECG) parameters (QT, QTc, Tpe, and TPE/QTc ratios), which are ventricular repolarization markers. Subjects and methods: A total of 140 BAD and 253 SCZ patients were included in the study. Age, blood test results (fasting blood glucose, LDL-HDL-TC levels, hemogram values), blood pressure and heart rate, smoking status, antihypertensive drug use, and FHRS were calculated from the patient files, and sociodemographic information was recorded. In addition, ECG calculations were performed, and QT, QTc, TPe, TPe/QTc ratios and heart rate were measured. Results: When we evaluated the cardiac risk indexes of SCZ and BAD patients, we detected that FHRS was higher in smokers, female patients, and those with other medical diseases such as diabetes mellitus (DM) (p<0.05). In addition, we found that QTc rates, markers of ventricular repolarization, were associated with FHRS, the number of antipsychotics used, patient age, disease duration, and the number of hospitalizations. TPe and QT rates were found to increase in parallel with FHRS. In addition, a positive correlation was found between QTc rates in females, patients with DM, and those using additional medical drugs. (p<0.05) Conclusions: In BAD and SCZ patients, diabetes diagnosis, other medical drug use, a high Framingham heart score, the number of antipsychotics, the disease duration, the patient’s age, and an increased number of hospitalizations may increase the risk of cardiac arrhythmia. Therefore, possible cardiac risk should be considered in patients with chronic drug use, such as BAD and SCZ. Regulating the treatment and follow-up of this group of patients against possible cardiac risks will reduce cardiac mortality and morbidity

Comparison of Sociodemographic and Clinical Characteristics of Patients with Bipolar Disorder with and without Guardianship Decision

Aim:We aimed to compare the sociodemographic and clinical variables of the patients with bipolar disorder (BD), who were required guardianship by Mental Health Hospital’s Health Board.Materials and Methods:This retrospective study consisted of 201 patients with BD-1, aged between 18 and 65 years, who were sent to medical health board in order to prepare a report on whether guardianship was required by the courts. Sociodemographic and clinical variables data form including age, marital status, education, employment, the number of episodes, the history of electroconvulsive therapy (ECT), the type of medication, the number of hospitalization, and the history of suicide were used.Results:One-hundred (49.75%) patients with BD were required guardianship decision (GD). The mean age of the group with GD (43.57±11.53 years) was significantly higher than the group without GD (39.54±10.73 years). There was a significant relationship between GD and marital status and employment. The group with GD had significantly higher number of total and manic episodes, duration of hospitalization, and duration of illness than the group without GD. A significant relationship was found between GD and medical comorbidity, history of ECT, the presence of psychotic Manndelusion, and treatment with antipsychotic, lithium and valproic acid. Paranoid-persecution, reference, and bizarre types of delusion were found to be related to GD.Conclusion:A significant relationship was found between GD and marital status, employment, duration of illness, number and duration of hospitalizations, number of total and manic episodes, medical comorbidity, and history of ECT, presence of psychotic delusions, and type of treatment. Clinicians should be aware of these variables during the decision of guardianship for patients with BD

Resistant depressive disorder in a patient treated with antiretroviral drugs for HIV

WOS: 000388116800015

Paroxetine induced hypertension

WOS: 000388115900013

THE EFFECT OF EMOTIONAL DYSREGULATION AND IMPULSIVITY ON SUICIDALITY IN PATIENTS WITH BIPOLAR DISORDER

Background: We aimed to evaluate the effect of emotional dysregulation and impulsivity on suicidality in patients with bipolar disorder by comparing patients with bipolar disorder with healthy individuals. Subjects and methods: The study included 85 patients (59 women, 26 men) with bipolar disorder and education and agematched 65 (44 women, 21 men) healthy volunteers. The patient group was separated into 3 different groups if they have a suicide attempt history, or have suicidal ideation without attempt, or have neither suicide attempt nor ideation. Sociodemographic Form, The Difficulties in Emotion Regulation Scale (DERS), Barratt Impulsivity Scale (BIS-11), Scale for Suicidal Ideation, Suicide Behaviors Questionnaire scales were applied to the participants. Results: Patients with bipolar disorder (n=85) had significantly higher scores for emotion dysregulation and impulsivity than the healthy controls (p<0.001, p<0.001). The scores of DERS, BIS-11, Suicidal ideation, and Suicide behavior scores were significantly correlated. DERS Total and BIS Total scores of bipolar patients with suicide attempts were significantly higher than bipolar patients with suicidal ideation and bipolar patients with neither attempt nor ideation. According to the hierarchical regression analysis, strategies, clarity, and non-planning impulsiveness were found as the predictors of suicidal ideation in bipolar patients. Conclusions: Suicidal behavior has a significant relationship between emotional dysregulation and impulsivity in patients with BD. Clinicians must carefully evaluate emotional dysregulation and impulsivity among this population to develop treatment strategies in suicide prevention

Cognitive Behavioral Therapy and Eye Movement Desensitization and Reprocessing in Posttraumatic Stress Disorder

Bilişsel davranışçı terapi (BDT) ve göz hareketleri ile duyarsızlaştırma ve yeniden işleme (EMDR) uygulamaları, travma hastalarında son dönemde sık kullanılmaya başlanan tedavi yöntemlerindendir. Travma Sonrası Stres Bozukluğu (TSSB) ve diğer travma hastalarında bu iki tedavi yönteminin klinikte uygulanabilirliğinin artması ile, travma hastalarında tedavi başarısı giderek artmaktadır. Bu makalede, travma hastaları arasında sık olarak olarak görülen TSSB'nda, BDT ve EMDR yöntemlerinin, uygulama şekillerinin ve tedaviye olan etkilerinin gözden geçirilmesine çalışılmıştır. Bu yazı ile travma sonrası akut ve kronik seyir gösteren, birden fazla psikiyatrik belirti ile giden hastalıkların tedavisinde BDT ve yeni kullanılmakta olan EMDR yönteminin önemine vurgu yapılması amaçlanmıştır.Cognitive Behavioral Therapy and Eye Movement Desensitization and Reprocessing in Posttraumatic Stress Disorder Cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR) are the most common treatment methods that are practiced on trauma patients in recent years. With the increased applicability of these treatment models in Post Traumatic Stress Disorder (PTSD) and on other trauma patients, success rate of these treatments on trauma patients is increasing steadily. In this article, it is tried to review the application forms and effects of EMDR and CBT methods among patients with PTSD, which is a commonly seen trauma disorder. It is aimed in this article to emphasize the importance of CBT and a newly treatment EMDR in post-traumatic acute and chronic disorders with multiple psychiatric symptoms