Hyperprolactinemia and bone metabolism disorders due to antipsychotics in patients with schizophrenia [Şizofreni hastalarinda antipsikotik kullanimina bagli hiperprolaktinemi ve kemik metabolizma bozukluklari]

Schizophrenia has influenced approximately 1% of the general population. If the schizophrenia spectrum disorders (schizoid personality disorder, schizotypal personality disorder, schizoaffective disorder and paranoid disorder) have been included, this rate would increase to 5%. Psychiatric disorders, sun light deficiency, inadequate exercise, smoking and polidipsia are predisposing factors for decreased bone mineral density and disruption in bone metabolism of patients with schizophrenia and schizoaffective disorders. The effects of antipsychotic drugs on bone metabolism are closely associated with hyperprolactinemia and hypogonadal states. Although in this group of patients hyperprolactinemia is seen commonly, bone metabolism disorders are not investigated and not included among routine procedures. That way they are usually missed out of sight. Recently, interest on bone metabolism disorders increase. Patients with bone metabolism disorder should be acknowledged that they must add calcium and vitamin D supplements to diet; regularly lose weight, do exercise, avoid cigarette, caffeine and alcohol; benefit good enough of sunshine. Using antipsychotics with no effect on prolactine levels, hormone replacement therapy and biophosphonate supplement is recommended for the treatment of this situation

Death anxiety in elderly cases [Yaşli bireylerde ölüm kaygisi]

Objective: The purpose of this study was to find out the level of death anxiety evaluate its relationship with several sociodemographic and clinical variables among elderly patients who have been referred to psychiatry outpatient clinics with consultation from other outpatient clinics in an university hospital. Methods: Two hundred patients (117 male, 83 female) who have been referred to Çukurova University Medical Faculty Psychiatry outpatient clinics via consultation were included in the present study. A formal psychiatric interview were conducted with all cases, and demographic and clinical variables were recorded thereafter. After the interview, all patients completed Geriatric Depression Scale (GDS), State and Trait Anxiety Inventory (STAI), Templer Death Anxiety Scale (DAS), Death Depression Scale (DDS) and Short Form-36 (SF-36) quality of life scale. Results: Of all patients included in the present study, 58,5% were female with an average age of 67.16±5.0 for whole group. The mean DAS score for whole group was 7.7. There was a mild positive correlation between SF-36 and DAS scores. The same correlation was alos valid between SF-36 and DDS scores. Evaluation of the relationship between demographic variables and scale scores revealed positive correlation between DAS score and the number of children of the patients, while a negative correlation was present between DAS and length of education. There were no significant differences in DAS and DDS scores with regards to physical disorder type. The presence of bereavement within one year time was not a significant factor for change in DAS scores while there was a significant increase in death anxiety among patients who had frequent death thoughts in the last month. Conclusion: The results of this study presented significant relationship between death anxiety and length of education, number of children and frequency of death thoughts among elderly patients. No such relationship could be determined for the type of physical disease. Prospective studies carefully searching for different variables in elderly cases would reveal and help us to understand the importance of death anxiety and its impact on courses of physical and mental disorders

Sociodemographic and clinical characteristics of inpatients with schizophrenia in psychiatry clinics [Psikiyatri Kliniginde Yatarak Tedavi Gören izofreni Hastalarinin Sosyodemografik ve Klinik Özellikleri]

Objective: The aim of study as to determine the clinical and sociodemographic characteristics of the inpatients with the diagnosis of schizophrenia between the years 2010-2014. Patients were grouped according to the gender and age of onset and these groups were compared. Method: 208 patients who had been diagnosed with schizophrenia according to DSM IV TR between the years 2010-2014. Sociodemographic and clinical data form, Scale for the Assessment of Positive Symptoms(SAPS) and Scale for the Assessment of Negative Symptoms(SANS), Hamilton Depression Rating Scale and Insight Assessment Scale were filled by scanning previous patient files. Results: 107(51,4%) of the patients included in this study were male. Mean age of onset of schizophrenia was 23,82±9,78. There was no significant difference between men and women in terms of age at onset. The rate of patients with one or more delusions was 98,6 % (n:205), the rate of patients with one more halucinations was 59,6 % (n:124). Lifetime smoking, alcohol and substance abuse and legal problem rates were higher in male patients. Lifetime history of suicide and SAPS scores were higher in female patients. Family history of psychiatric disorders was higher in early onset schizophrenia patients(<40 age). Conclusion: The study which determined wider and homogeneous distribution samples in this subject and at same time meeting patients and their families may contribute to identify the clinical features of the disease more detailed. © 2017 ANP Publishing. All rights reserved

Influence of mood stabilizers on bone metabolism [Duygudurum düzenleyicilerin kemik metabolizmasi üzerine etkileri]

Mood disorders are common and chronic disorders in general population. During acute episodes and chronic treatment of mood disorders, lithium and several antiepileptic drugs (i.e. valproic acid, carbamazepine and lamotrigine) are used as mood stabilizers. Many different adverse effects could be observed during the chronic course of these disorders due to long term drug treatment. Because of their rare prevalence and insufficient evaluation, some of these adverse effects could be missed by the physician. One of such adverse effects is the influence of mood stabilizers on bone metabolism. There is relatively scarce number of research about the influence of mood stabilizers on bone metabolism in literature. Since some of these drugs are also antiepileptic drugs (valproic acid, carbamazepine, lamotrigine), the studies conducted on this issue mainly involved epileptic patients in pediatric age group. The influence and the mechanism of action of these drugs on adult bone metabolism has not been yet clarified. Thus there is not any exact treatment algorithm that could be used among such patients. For all patients, risk and benefit ration of the drugs should be estimated and drugs should be used accordingly. In this paper, the relationship between mood stabilizer drug use and bone metabolism, the mechanism associated with the development of secondary osteoporosis, prevention of such adverse effects and treatment procedures have bben discussed and reviewed briefly

Assessment of dyadic adjustment and sexual functions in patients with bipolar disorder

Introduciton: There are limited studies investigating the relation between dyadic adjustment, and sexual functions. The aim of this study was to compare patients with bipolar disorder (BD) in euthymic phase with healthy controls, and confirm our hypothesis which we expect to find that dyadic adjustment is negatively affected in bipolar patients with sexual dysfunctions (SDs). Methods: A total of 50 euthymic bipolar patients (32 female, 18 male), and 50 healthy individuals as a control group (27 female, 23 male) were included in the study. A data form for socio-demographic features and two other forms for clinical characteristics of bipolar disorder and sexual functions have been filled by clinician. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-4) Axis I was used to determine axis I psychiatric disorders. All patients completed Golombok Rust Inventory of Sexual Satisfaction (GRISS), and Dyadic Adjustment Scale (DAS). Results: Twenty-five (50%) of bipolar patients, and 13 (48.8%) of healthy controls were found to have SDs. There was a significant difference between bipolar patients, and healthy controls in regard to the presence of SDs (p=0.013). Dissatisfaction, communication, and anorgasmia subscale scores, and total scores of GRISS was found to be higher in female patients with BD. Intercourse frequency, impotence and premature ejaculation subscale scores and total scores of GRISS were higher in male patient group than healthy controls. When bipolar patients and healthy controls were compared, there was a significant difference between dyadic cohesion and affectional expression scores as measured by DAS. As a result of the univariate and regression analyzes, it was determined that the variable affecting the dyadic adjustment in bipolar patients was affected by sexual dysfunction rather than disease presence. Conclusion: The results of this study have shown that the prevalence rate of SDs is higher in bipolar patients than healthy individuals. It was determined that the variable affecting the dyadic adjustment of patients with BB was affected by sexual function rather than disease presence. The presence of SDs in bipolar patients have negative effects on dyadic adjustment. © 2017 by Turkish Association of Neuropsychiatry.Firat University Scientific Research Projects Management Unit: TF2013LTP25Financial Disclosure: It was supported by Cukurova University Scientific Research Projects Unit (Project no: TF2013LTP25)