Delusional Parasitosis: Clinical Features, Diagnosis and Treatment

Delusional parasitosis is a delusional disorder in which the patient has the false and persistent belief that he is infested by some type of parasite or small living creatures. The disease has been called under different names such as “Ekbom syndrome” or psychogenic parasitosis in the last century. Delusional parasitosis is divided into primary, secondary functional and secondary organic groups. The female-to-male ratio in delusional parasitosis is approximately 2:1.Delusional parasitosis is associated in 5-15% of shared psychotic disorder and can run within a family (folie a familie). The diagnosis is one of exclusion, and other diseases that can also cause a sensation of itching should be considered, investigated, and treated if present. Lack of treatment might cause delusional symptoms to gain chronicity, and might further complicate treatment response. Antipsychotics, antidepressants, electroconvulsive therapy, and in the presence of dermatological lesions some topical dermatological agents and antihistaminics are used in the treatment of this disorder

Suicide in Obsessive Compulsive and Related Disorders

Suicide is a complex term. Suicide attempts are common in women, but completed suicide rates are higher in men. Several demographic factors, stressful life events, previous suicide attempts, childhood abuse, physical or psychiatric disorders are risk factors for suicide. Suicide rates in a variety of mental disorders is more than the normal population. Data on rates and risk factors of suicide in patients with obsessive-compulsive disorder and related disorders are limited. Present data are often associated with patients with obsessive compulsive disorder and body dysmorphic disorder. Lifetime suicidal ideation rates in patients with obsessive compulsive disorder is within a range of 36-63%. Any comorbid psychiatric diagnosis is an important risk factor for suicide in this disorder. This article aims to review the relationship between suicide and obsessive compulsive and related disorders [Archives Medical Review Journal 2015; 24(3.000): 402-413

Clinical features of psychiatric inpatients with obsessive compulsive disorder

WOS: 000399405200020Purpose: The aim of this study was to determine the clinical and sociodemographic characteristics of the inpatients admitted in a university psychiatry clinic with a diagnosis of obsessive-compulsive disorder in ten years period Material and Methods: Patients who had been diagnosed with obsessive compulsive disorder according to DSM IV TR and hospitalized in Cukurova University Faculty of Medicine Balcali Hospital Department of Psychiatry between 2006 and 2015 were included. Data were obtained from hospital records of patients. Sociodemographic and clinical data form was completed by scanning previous patient files. Patients were grouped according to the gender, age of onset and the family history of psychiatric disorders and these groups were compared Results: Forty one of the patients were female (57.7%) and 30 of them were male (42.3%). Mean age of patients was 25 +/- 10,04 years; first treatment age was 27.75 +/- 9.19 and mean duration of untreated illness was 32.82 +/- 48.06 months. There was a significant difference in patients, when first treatment age and mean duration of untreated illness were examined by gender. In patients with family history of obsessive-compulsive disorder, the mean duration of untreated illness was higher Conclusion: Obsessive compulsive disorder is a chronic disorder with significant risk factors for prognosi

Sleep and suicide relationship in patients with obsessive-compulsive disorder

WOS: 000428761600005Objective: The data about sleep quality and suicide relationship in patients with obsessive-compulsive disorder (OCD) is limited. In this study, we aimed to investigate the hypothesis that there might be a relationship between sleep quality and suicide in the OCD patients with compare the control group. Methods: A total of 50 patients with OCD (31 female, 19 male) and 40 healthy (24 female, 16 male) individuals as a control group were included in the study. A data form for sociodemographic features, one other forms for clinical characteristics of OCD and Yale Brown Obsessive Compulsive Scale (YB-OCS) have been filled by clinician. After the interview, all patients completed Pittsburgh Sleep Quality Index (PSQI) and Suicide Behavior Scale (SBS). Results: Six (12%) of the OCD patients had lifelong suicide attempts and twenty (40%) had lifelong suicide ideation. When OCD patients and healthy controls were compared, PSQI-2, PSQI-3, PSQI-5, PSQI-6, SBS-1, SBS-2, SBS3 and SBS total scores in patients with OCD were higher than healthy controls. In patients group with lifelong suicide ideations, PSQI-1 and PSQI-6 scores were higher. In patients group with lifelong suicide attempts, PSQI-6 scores were higher. In OCD patients, statistically significant correlations were detected between SBS-1 and PSQI-1, PSQI-6; SBS-3 and PSQI-6. This correlations were not observed in the control group. Conclusion: As a result of this study, it has been shown that the subjective sleep quality of the last 1 month in OCD patients and the intake of additional sleeping pills may be related to past suicidal thoughts and attempts. It may be appropriate to monitor OCD patients with subjective sleep quality impairment and use of additional medication more frequently in terms of suicide risk. In this issue, follow-up studies are needed to include more OCD patients

Compulsive buying disorder: an untreated patient for 20 years

WOS: 000399405200026Compulsive buying disorder is characterized by impulsive drives and compulsive behaviors (buying unneeded things), personal distress, impaired social and vocational functioning and financial problems. In this case report, we presented diagnostic and treatment process of 49 year old, female patient who had complaints amnesia, weight loss and insomnia. In her medical history, she had compulsive buying disorder for nearly twenty years but untreated until her current evaluation. Comorbid psychiatric disorders started in the last two months which expedited her current referral

Humanitarian Supply Chain Management - An Overview

Disasters recently received the attention of the Operations Research community due to the great potential of improving disaster related operations through the use of analytical tools, and the impact on people that this implies. In this introductory article, we describe the main characteristics of disaster supply chains, and we highlight the particular issues that are faced when managing these supply chains. We illustrate how Operations Research tools can be used to make better decisions, taking debris management operations as an example, and discuss potential general research directions in this area

Dermatological side effects of psychotropic drugs and treatment approaches

WOS: 000260565800013There are several different side effects of psychotropic drugs used in psychiatric disorders. One of these is dermatologic side effects. The majority of adverse cutaneous effects are benign and easily treated. However serious adverse effect can be seen such as Stevens Johnson Syndrome, toxic epidermal necrolysis, exfoliative dermatitis, vosculitis and drug hypersensitivity syndrome with eosinophilia. The most frequently reported cutaneous adverse effects of psychotropic medications include: urticaric, exanthematous reactions, pruritus, photosensitivity, Pi mentation, fix drug eruptions, alopecia, erythema multiforme, Stevens,Con syndrome, toxic epidermal necrolysis, drug hypersensitivity syndrome with eosinofilia and systemic symptoms, exfoliative dermatitis, acneiform eruption, psoriasiform reactions, lichenoid eruption, lupus erythematosus, acute generalized exanthemotous pustulosis, pseudolymphoma and hyperhicrosis. Some systemic symptoms such as fever, lymphadenopathy and abnormal hemalological examination may contribute to these side effects. In this case, patient should be hospitalized and monitored carefully. Dermatological adverse effects of psychotropic medications might increase due to a history of former drug eruptions and multiple drug usage. In this case if is recommended to search dermatological sources which include compilation of dermatological side effects due to medication and to select the most appropriate drug for the patient. Dermatological side effects of antidepressants were reported more frequently in women than men whereas male patient treated with lithium had more side effects. Children treated with lamotrigine had Stevens Johnson syndrome more frequently than adults. Almost all of the antidepressant and antipsychotic drugs cause urticaria, exanthematous reactions, pruritus and photosensitivity. In antidepressant group fluoxetine, sertraline, amitriptiline and imipramine; in antipsychotic group chlorpromazine, clozapine and risperidone seems to cause more adverse dermatological effects than others. This might be due to frequency of drug use. Almost all of the mood stabilizers cause urticaria, exanthematous reactions and pruritus. When we consider all the psychotropic drugs mood stabilizers seem to cause more serious side effects than others. Former drug history and related cutaneous side effects should be carefully investigated before starling the psychotropic medication. Besides the patients should be informed about the possible dermatological side effects. Patients should be followed for possible dermatological reactions after starting the therapy. If a skin eruption occurs, it is generally advisable to refer the patient to a dermatologist and discontinue the drug and to consider switching to another class of agent. In this manuscript we reviewed the most frequently observed dermatological adverse effects due to commonly used psychotropic drugs

Death anxiety in elderly cases

WOS: 000290031900007Objective: 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 Cukurova University Medical Faculty Psychiatry out-patient 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. (Anatolian Journal of Psychiatry 2011; 12:37-43

Hyperprolactinemia and bone metabolism disorders due to antipsychotics in patients with schizophrenia

WOS: 000273170700012Schizophrenia 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. (Anatolian Journal of Psychiatry 2009; 10:336-342

Sociodemographic and Clinical Characteristics of inpatients with Schizophrenia in Psychiatry Clinics

WOS: 000426053800005Objective: 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