Psychiatric Comorbidity in the Subtypes of ADHD in Children and Adolescents with ADHD According to DSM-IV

Introduction: The prevalence rate of psychiatric comorbidity in children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) was 60-80%. The objective of this study was to examine comorbid disorders associated with ADHD and the subtypes of ADHD in children and adolescents with the diagnosis of ADHD. Method: The study included 326 children and adolescents aged between 8-15 years who were diagnosed with ADHD for the first time as a result of an interview by psychiatry, in a child adolescent psychiatry clinic in Izmir. Sociodemographic form, Turgay DSM-IV Disruptive Behavior Disorders Rating Scale and Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version were used to assess psychiatric comorbidity. Results: The comorbidities accompanied ADHD were disruptive behavior disorder (28.8%), depressive disorder (13.2%), obsessive-compulsive disorder (9.5%) and anxiety disorder (6.1%), in respectively. When the subtypes of ADHD were assessed according to psychiatric comorbidity, oppositional defiant disorder and conduct disorder were frequently seen with ADHD combined type, whereas anxiety disorder was seen more frequent in children diagnosed with ADHD inattentive type. Discussion: Especially the presents of comorbidities in cases with ADHD Combined type increases the severity of disease, causes to retard in responses to treatment and exacerbates prognosis. Therefore, it is very important to determine which psychiatric diagnosis accompany with ADHD

Personality: Description, Classification and Evaluation

Many descriptions and classifications of personality have been made to understand and acknowledge human being through out the history. During the developmental process of psychiatry, almost every school defined and assessed personality regarding to their own perspective. As DSM (Diagnostical and Statistical Manual of Mental Disorders) and ICD (International Classification of Diseases) being available to common usage, scientists conducted studies to set a common terminology for personality. Categorical and dimensional approaches are the most fundamentally different assessment strategies in the research and clinical aspects about personality. While categorical approach views the personality as dichotomies which consists of different groups, dimensional approach aims to describe the personality on the basis of dimensions, thus suggests that the personality is a structure formed by definite dimensions. Several advantages and disadvantages can be noticed when descriptions of personality and tools for the evaluation of personality are reviewed. When the section making suggestions about personality disorder in DSM-5 is evaluated, it is seen that it aims to restructure the personality disorder diagnostic group according to new findings and critiques. In this article, the description of personality throughout the history, dimensional, categorical and cognitive approaches to personality, the features of the tools that are used to assess and measure the personality are reviewed

Agoraphobia and Panic Disorder: A Comparative Study

Aim: In this study we aim to get more information about agoraphobia (AG) which is an independent diagnosis in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5j and to evaluate overlaps or differences between agoraphobia and panic disorder (PD) upon sociodemographic features and comorbidity with considering relation of these two disorders. Material and Method: Sociodemographic Data Form was given and Structural Clinical Interview for DSM Axis I Disorders (SCID-I) was applied to 33 patients diagnosed as AG and 34 patients diagnosed as PD with AG (PDA). Results: AG group consisted of 21 females (63.1%), 12 males (36P5), totally 33 patients and PDA group consisted of 23 females (67.615o), 11 males (32.4%), totally 34 patients. Mean age of onset was 32.4 10.2 in PDA group and 31.1 12.1 in AG group. According to sociodemographic features, violence in family and smoking rates were significantly higher in PDA group than AG group. Major Depressive Disorder (MDD) as a comorbidity was higher in PDA group. Discussion: In this study, we tried to identify the overlaps and differences of FDA and AG. For a better recognition of AG, further studies are needed

The effects of childhood emotional abuse on aggressive obsessions among patients with obsessive compulsive disorder may be mediated by symptoms of depression and anxiety

OBJECTIVE: The purpose of this study was to evaluate the relationship between childhood traumas (CTs) and severity and symptom dimensions of Obsessive Compulsive Disorder (OCD). METHOD: One hundred and sixty (160) patients diagnosed with OCD were included. The Yale-Brown Obsessive-Compulsive Scale (YBOCS), the Childhood Trauma Questionnaire (CTQ), the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI) were applied to the participants. RESULTS: According to a cut-off score of > 35 for CTQ total score, 71 (44.4%) OCD patients had no CT history and 89 (55.6%) OCD patients had CTs history. There were no significant difference between the two groups with regard to YBOCS total score or to obsessions and compulsions except aggressive obsessions. The associations between aggressive obsessions, BDI total score, BAI total score and emotional abuse were statistically significant, but the correlation between aggressive obsessions and emotional abuse was no longer significant after controlling for BDI and BAI total scores. In the parallel multiple mediator model analysis, there were not statistically significant mediator effects of depression and anxiety variables in the relationship between emotional abuse and aggressive obsessions. Mobility in childhood was significantly correlated with physical abuse, and this correlation was still significant after controlling for BDI and BAI total scores. BDI total score was significantly associated with sexual abuse. CONCLUSION: The relationship between CTs and OCD should be reconsidered in light of other contributing factors such as comorbidity

Bicytopenia associated with paroxetine: A case report

KURU, ERKAN/0000-0003-1949-4007WOS: 000435654600016PubMed: 29930235Paroxetine is a selective serotonin reuptake inhibitor (SSRI), which is used to treat depression, obsessivecompulsive disorder, panic disorder, social anxiety disorder, generalized anxiety disorder, and post-traumatic stress disorder. In addition to general SSRI adverse effects (nausea, vomiting, indigestion, abdominal pain, diarrhea, rash, sweating, agitation, anxiety, headache, insomnia, chills, sexual dysfunction, hyponatremia), antimuscarinic effects, sedation, extrapyramidal symptoms, and discontinuation symptoms may be more common with paroxetine (Taylor et al. 2015)

(HMRS)-H-1 results of hippocampus in the patients with obsessive-compulsive disorder before and aft er cognitive behavioral therapy

Objective. In the present study, we examined the effects of cognitive behavioral therapy (CBT) on the hippocampal neurochemistry in patients with obsessive-compulsive disorder (OCD). Methods. Twelve patients with OCD and same number of healthy controls were included into the study. Neurochemical variables of the hippocampus were measured before and after the CBT treatment in the patient group. Results. At baseline, the patients with OCD had significantly lower ratio of N-acetyl-l-aspartate/choline (NAA/CHO) compared with that of healthy control subjects. When comparing pre-treatment results of the patient group with those of post-treatment ones using paired t-test, we found that NAA/CHO ratio increased from 2.47 +/- 0.64 to 3.66 +/- 0.88, with a statisical significance. Conclusions. The findings may implicate that CBT increases the level of NAA which is a marker of neuronal integrity

Validity and Reliability of the Catastrophic Cognitions Questionnaire-Turkish Version

Aim: Importance of catastrophic cognitions is well known for the development and maintance of panic disorder. Catastrophic Cognitions Questionnaire (CCQ) measures thoughts associated with danger and was originally developed by Khawaja (1 992). In this study, it is aimed to evaluate the validity and reliability of CCQ-Turkish version. Material and Method: CCQ was administered to 250 patients with panic disorder. Turkish version of CCQ was created by translation, back-translation and pilot assessment. Fools demographic Data Form and CCQ Turkish version were administered to parcipants. Reliability of CCQ was analyzed by test-retest correlation, split-half technique. Cronbach's alpha coefficient. Construct validity was evaluated by factor analysis after the Kaiser-Meyer-Olkin (KM 0) and Bartlett test had been performed. Principal component analysis and varimax rotation were used for factor analysis. Results: Fifty-five point six percent (n=139) of the participants were female and fourty-four point four percent (n=111) were male. Internal consistency of the questionnaire was calculated 0.920 by Cronbach alpha. In analysis performed by split-half method reliability coefficients of half questionnaire were found as 0.917 and 0.832. Again spearmenbrown coefficient was found as 0.875 by the same analysis. Factor analysis revealed five basic factors. These five factors explained,566.2 of the total variance. Discussion: The results of this study show that the Turkish version of CCQ is a reliable and valid scale

Reliability and validity study of the Turkish version of the remission from depression questionnaire

Objective: In current psychiatric practice, the principal goal in the treatment of patients with Major Depressive Disorder (MDD) is to achieve remission. Symptom-based definitions of remission do not adequately reflect the treatment expectations of depressed patients. The "Remission from Depression Questionnaire (RDQ)" evaluates not only symptoms of depression but also patients' other psychiatric symptoms, positive mental health, ability to function in various contexts, sense of well-being, life satisfaction and ability to cope. The first aim of this study is to assess the reliability and validity of the RDQ's Turkish language version. Secondly, it purposes to compare the scale with the Hamilton Depression Rating Scale (HDRS) and the Beck Depression Inventory (BDI) in psychometric terms. Method: 106 outpatients who met MDD diagnosis criteria according to Diasnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) were included in the study. After the translation and back-translation processes, the RDQ, HDRS, BDI, Beck Anxiety Inventory and World Health Organization Quality of Life survey (short version) were administered. Results: All item-scale correlations were found to be statistically significant, and the median value for correlations was .534. The RDQ Turkish version demostrated excellent internal consistency with Cronbach's alpha coefficient of .945. The test-retest reliability value for the overall RDQ was .908. The correlations between the RDQ subscales and psychosocial functioning, quality of life areas, anxiety severity and depression severity were evaluated and convergent validity analysis was performed, revealing significant relationships between the RDQ total and subscale scores and the other applied scales. For a discriminant validity assessment, the RDQ scores and subscales of two groups made up of the patients who were in remission and those who were not in remission were compared with the HDRS score (with a cutoff point of 7 points) or BDI (with a cutoff point of 17 points) score. We conducted a ROC curve analysis to determine the most appropriate cutoff score for the RDQ. When the cutoff value 7 of HDRS were used, sensitivity was found to be 86.7% for a cutoff value of 43 for the RDQ, and specificity was 73.5%. When the cutoff value 17 of BDI were used, the sensitivity was 85.5% and the specificity was 75% for a cutoff value of 43 for the RDQ. Conclusion: Our findings show that the Turkish version of RDQ is a reliable and valid scale

Normative data and factorial structure of the Turkish version of the temperament and character inventory-revised (Turkish TCI-R)

Objective In this study, we aimed to examine the validity, reliability, and factor structure of the TCI-R in a Turkish sample. Methods Participants were 1026 (786 female, 240 male) college students at Hasan Kalyoncu University in Turkey. The study protocol was approved by the local Ethics Committee. Sociodemographic information of the participants was collected and the TCI-R, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Personality Belief Questionnaire (PBQ) were administered. All statistical analyses were performed by using SPSS version 24 for Windows. Results The internal consistency was satisfactory for all dimensions (Cronbach alpha coefficients above 0.7). The highest Cronbach alpha was found for Persistence Dimension (0.92) and the lowest Cronbach alpha was found for Novelty Seeking Dimension (0.73) and test-retest correlation coefficients for all dimensions were relatively high and statistically significant. TCI-R temperament and character scales were found significantly correlated with the BDI, the BAI, and the PBQ total scores. A principal-components analysis with Promax rotation yielded four factors with an Eigenvalue greater than one, representing 62.67% of the total variance for temperament dimension. A principal-components analysis with Promax rotation yielded three factors with an Eigenvalue greater than one, representing 56.14% of the total variance for character dimension. The addition of four new subscales to the original scale for Persistence has produced a very reliable dimension in the TCI-R with the loadings ranging from 0.82 to 0.86. Conclusions Our findings suggested that Turkish TCI-R was a valid and reliable tool with a robust factorial structure for further use in the assessing of personality psychopathology in clinical populations in Turkey

From the First Episode to Recurrences: The Role of Automatic Thoughts and Dysfunctional Attitudes in Major Depressive Disorder

Negative automatic thoughts (NAT) and dysfunctional attitudes (DA) are causal elements in the onset and maintenance of depression. It has previously been reported that NATs become more prevalent during depressive episodes. DAs are known to be influencing both the first and the recurrent depressive episodes. This study aims to focus on the differences observed in the depressive cognitions of the first episode and the recurrently depressed patients, and to investigate if negative cognitions may be predictive of a depressive recurrence. The hypothesis of the study is that automatic thoughts and dysfunctional attitudes of adult depressed patients might be predictive of a recurrence. For the present study, 100 first episode depressed, 100 recurrent episode depressed, and 100 healthy control subjects were recruited. All patients were diagnosed by a structured clinical interview according to the DSM-IV-TR criteria, and any patients with a comorbid diagnosis were excluded. The participants were asked to complete the Beck Depression Inventory (BDI), the Automatic Thoughts Questionnaire (ATQ), and the Dysfunctional Attitude Scale (DAS). The groups were compared with each other on the scores of their cognitive scales, and hierarchical regression analyses were undertaken to predict the number of recurrences. The ATQ and DAS scores differentiated all three groups, and the highest scores were obtained by the recurrently depressed patients. The hierarchical regression analyses for the prediction of the number of recurrences showed that the highest partial correlation was for the perfectionistic attitude. Correlational analyses revealed that the highest correlation was between the number of recurrences, and the perfectionistic attitude. Our results have indicated that the first episode depressed patients differ from the recurrently depressed patients in terms of their ATQ and DAS scores, and that the number of recurrences may best be predicted by the scores related to perfectionistic attitudes. These results suggest that some cognitions should selectively be addressed in psychotherapy for the prevention of depressive recurrences