COULD AFFECTIVE TEMPERAMENT PREDICT OBSESSIVE COMPULSIVE SYMPTOM DIMENSIONS?

Background: In this study, we aimed to investigate the relationship between affective temperament characteristics and obsessive- compulsive disorder (OCD) symptom dimensions and severity. Subjects and Methods: 100 patients diagnosed with OCD and 100 healthy controls by random sampling method were included in the study. SCID-5-CV was administered to all participants. Dimensional Obsessive-Compulsive Scale (DOCS), Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire (TEMPS-A), Beck Anxiety (BAI), Depression Inventories (BDI) were provided to all participants. p<0.05 was taken as statistically significant. Results: It was found that cyclothymic temperament predicted all OCD symptom dimensions except contamination dimension, and predicted the OCD severity. Moreover, irritable temperament predicted the OCD symmetry dimension. Conclusion: In our study, the first study in terms of scrutinizing the relationship between symptom dimensions of OCD and affective temperament, it was revealed that irritable and cyclothymic temperament significantly predicted the dimensions of OCD, and cyclothymic temperament was associated with OCD severity. Affective temperaments appear to make a remarkable contribution to OCD heterogeneity

Cognitive-Behavioral Theory and Treatment of Antisocial Personality Disorder

Antisocial personality disorder (ASPD) has a distinct cognitive profile according to cognitive theory of personality disorders. Antisocial individuals’ view of the world is personal rather than interpersonal. They cannot accept another’s point of view over their own. As such, they cannot take on the role of another. Their actions are not based on choices in a social sense because of this cognitive limitation. Cognitive theory of personality disorders conceptualizes personality disorder including the ASPD, according to their basic beliefs or schemas. The content of beliefs can vary in different personality disorders. Antisocial patients view themselves as loners, autonomous, and strong. Some of them see themselves as having been abused and mistreated by society and therefore justify victimizing others because they believe that they have been victimized. Their view about other people is very negative; they see others as exploitative and thus deserving of being exploited in retaliation. In this chapter, after overviewing general features of ASPD, we aim to give an explanation how cognitive behavioral therapy (CBT) conceptualizes personality disorders in general and ASPD in particular and highlight the important implementations of CBT and schema therapy

Urinary neopterine levels in patients with major depressive disorder: alterations after treatment with paroxetine and comparison with healthy controls

Background: A close relationship has been shown between mood disorders and pteridine levels. The aim of this study was to examine alterations in the urine neopterine levels of patients with major depressive disorder (MDD) who responded to paroxetine during the initial treatment and to compare their levels to those of healthy controls. Subjects and methods: Sixteen patients with major depression and 19 healthy controls were enrolled in the study. In order to assess depression severity levels, the Beck Depression Inventory, the Beck Anxiety Inventory, and the State-Trait Anxiety Inventory were administered. Urinary neopterine values that were measured using high pressure liquid chromatography (HPLC) were compared using non-parametric tests for the MDD patients before and after treatment. Urine neopterine levels in MDD patients before and after treatment were compared to those of the healthy control group. Results: Urinary neopterine levels were recorded as follows: For the MDD group before treatment the mean level was 187.92 +/- 54.79 mu mol/creatinine. The same group under treatment at 4 to 8 weeks was at 188.53 +/- 4962 mu mol/creatinine, and the healthy control group showed 150.57 +/- 152.98 mu mol/creatinine levels. There was no statistically significant difference in the urinary neopterine levels among the MDD patients before and after treatment (p=0.938). When urine neopterine levels in MDD patients before and after treatment were compared to those of the healthy control group, levels in the MDD group were found to be significantly higher (p=0.004 and p=0.005, respectively). Conclusions: Findings from the current study suggest that despite treatment response, depression is related to higher levels of urine neopterine. Paroxetine treatment has no significant effect on urine levels of neopterine in MDD patients

URINARY NEOPTERINE LEVELS IN PATIENTS WITH MAJOR DEPRESSIVE DISORDER: ALTERATIONS AFTER TREATMENT WITH PAROXETINE AND COMPARISON WITH HEALTHY CONTROLS

Background: A close relationship has been shown between mood disorders and pteridine levels. The aim of this study was to examine alterations in the urine neopterine levels of patients with major depressive disorder (MDD) who responded to paroxetine during the initial treatment and to compare their levels to those of healthy controls. Subjects and methods: Sixteen patients with major depression and 19 healthy controls were enrolled in the study. In order to assess depression severity levels, the Beck Depression Inventory, the Beck Anxiety Inventory, and the State-Trait Anxiety Inventory were administered. Urinary neopterine values that were measured using high pressure liquid chromatography (HPLC) were compared using non-parametric tests for the MDD patients before and after treatment. Urine neopterine levels in MDD patients before and after treatment were compared to those of the healthy control group. Results: Urinary neopterine levels were recorded as follows: For the MDD group before treatment the mean level was 187.92±54.79 μmol/creatinine. The same group under treatment at 4 to 8 weeks was at 188.53±4962 μmol/creatinine, and the healthy control group showed 150.57±152.98 μmol/creatinine levels. There was no statistically significant difference in the urinary neopterine levels among the MDD patients before and after treatment (p=0.938). When urine neopterine levels in MDD patients before and after treatment were compared to those of the healthy control group, levels in the MDD group were found to be significantly higher (p=0.004 and p=0.005, respectively). Conclusions: Findings from the current study suggest that despite treatment response, depression is related to higher levels of urine neopterine. Paroxetine treatment has no significant effect on urine levels of neopterine in MDD patients

The relationship between temperament and character features, and social problem solving in psychiatric patients who attempted suicide with drugs: preliminary results

Objective: In order to gather information in a broader sample, the aims of this preliminary study were: 1) to identify psychiatric diagnoses and any history of suicidal thoughts and attempts in people who attempt suicide with drugs, 2) to evaluate the temperament and character features, social problem solving skills of these patients in relation to sociodemographic data and 3) to analyze the correlations between these factors. Methods: Sixty patients between 16 and 49 years old participated in this study. A Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), a Sociodemographic Data Form, the Beck Depression Inventory (BDI), Temperament and Character Inventory (TCI) and Social Problem Solving Inventory (SPSI) were administered to the participants. Results: According to the SCID-I, 23 (38.3%) of the participants had a major depressive disorder, and 39 (65%) of the participants had a history of previous suicide attempts before this admission. There was a significant relationship between self-esteem scores and the incidence of previous suicide attempts. There were significant (negative) correlations between the harm avoidance, reward dependence, self-directedness and cooperativeness dimensions of the TCI and the problem orientation and problem solving skills subscales of the SPSI. Conclusion: Psychiatric disorders are common in individuals who attempt suicide with drugs. These individuals may have a history of one or more suicide attempts before admission. In addition to differences in temperament and character features, this study found significant disorders of cognition and behavior in individuals that had attempted suicide. This result may indicate that dimensions of temperament and character can provide significant indications for cognitive and behavioral disorders. (Anatolian Journal of Psychiatry 2014; 15:31-38

The relation between level of psychological symptoms and success in distinguishing components in thought record form and self evaluation in Turkish psychotherapy trainees

Introduction: Psychopathology affects the evaluation of feelings, thoughts, beliefs, behaviors, daily situations and self-image negatively. These components of feelings, thoughts, beliefs and behaviors have rarely been considered in mental health professionals in Turkey. As part of an assignment in a Cognitive Behavioral Therapy Class, it was observed that trainees had difficulties in distinguishing between thoughts vs. emotions, beliefs vs. thoughts, and situations vs. thoughts. In the present study, we would like to examine the relationship between the ability to distinguish among these components of emotions, thoughts, beliefs and behaviors in relation to psychological symptom levels and the evaluation of self-image among psychotherapy trainees. Method: The data are currently being collected from mental health professionals in cognitive behavioral therapy (CBT) trainings in Turkey. Respondents include Clinical Psychology Master Students at Hasan Kalyoncu University in Gaziantep and Ibn Haldun University in Istanbul. Other CBT trainees who are not attached to universities are also considered. In total, we aim to have approximately 60 mental health trainees. In addition to thought record form, participants will fill the Beck Depression Inventory, Beck Anxiety Inventory, SCL-90 Short-Form, Psychological Symptom Screening Questions and a short sociodemographic form, including some questions on evaluation of their self-image as future mental health professionals. Results: Analysis of variance, correlations and regression will be used to analyse the data, using IBM SPSS Statistics 25. Conclusions: We hope that the results of this study will make a contribution to support the professional development of the mental health trainees in Turkey

Aripiprazole Induced Acute Transient Bilateral Myopia: A Case Report

Background: Aripiprazole is an atypical antipsychotic drug. Acute transient myopia is a rare response to systemic medication. Unspecified ocular side effects of aripiprazole have rarely been reported. To the best of our knowledge, only 3 cases of aripiprazole induced myopia and diplopia have been reported in the literature. The aim of this article is to present a case of aripiprazole-induced acute transient myopia. Case Report: A 30 year-old woman underwent treatment for 5 days with aripiprazole and presented with bilateral painless blurred vision. The patient’s uncorrected visual acuity was 2/10 in both eyes and her best corrected visual acuity was 10/10 in both eyes with a refractive error of -3.00 diopters using a standard Snellen chart. Adding 2 mgs of biperiden a day to her treatment regimen decreased her blurred vision symptoms. After discontinuation of aripiprazole treatment and cross-switching to Paliperidon palmitate (75 mg/month) her blurred vision completely resolved. The same side effect did not re-occur when checked on her 6-month follow up. Conclusion: Ophthalmologists as well as psychiatrists must be aware of this myopic shift and should also ask these patients about medicine usage, especially aripiprazole. Ophthalmologists should consult the prescribing psychiatrist and stop the drug immediately to reverse this temporary condition

Comparison Of Metacognitions Between Obsessive Compulsive Disorder’s Subtypes And Normal Healthy Controls

Amaç: Sağlıklı kontrol grubu ile Obsesif Kompülsif Bozukluk (OKB) tanısı almış hastalar arasında ve ayrıca OKB'nin otojen ile reaktif alt tiplerinde üstbilişsel özelliklerin farklılık gösterip göstermediği incelendi. Yöntem: Bu çalışmaya Ankara Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi Psikiyatri Bölümüne poliklinikten başvuran hastalardan DSM-IV tanı ölçütlerine göre OKB tanısı almış 61 hasta ve kontrol grubu olarak da hastane personelinden benzer sosyodemografik özelliklerde seçilmiş 30 sağlıklı birey alınmıştır. Bu kişilere Sosyodemografik Veri Formu verilmiş; SCID-I, SCID-II, Üstbiliş Ölçeği (ÜBÖ-30) ve Yale-Brown Obsesyon Kompülsiyon Ölçeği (Y-BOCS) uygulanmıştır. Bulgular: OKB ve sağlıklı kontrol grubu karşılaştırıldığında "Olumlu İnançlar" alt ölçeği hariç diğer ÜBÖ-30 alt ölçekleri ve toplam puan ortalamalarında iki grup arasında istatistiksel olarak anlamlı fark saptanmıştır (p 0.05). Otojen ve reaktif alt tiplerinde üstbilişler karşılaştırıldığında istatistiksel olarak anlamlı bir fark gözlenmemiştir (p 0.05). Sonuç: OKB alt tiplerinde benzer üstbilişsel patolojilerin bulunuşu ve sağlıklı kişilerden farklı oluşu Üstbilişsel Terapinin OKB alt tip ayrımı gözetmeksizin bu alanda bir tedavi seçeneği olabileceği düşüncesini desteklemektedir. Bunun yanı sıra ÜBÖ-30 olumlu inançlar alt ölçeğinde normal sağlıklı grup ile OKB grubu arasında fark olmaması, aydınlatılması gereken noktalarda biridir. Bunun için OKB'da üstbiliş alanında daha fazla çalışmaya ihtiyaç vardır.Amaç: Sağlıklı kontrol grubu ile Obsesif Kompülsif Bozukluk (OKB) tanısı almış hastalar arasında ve ayrıca OKB’nin otojen ile reaktif alt tiplerinde üstbilişsel özelliklerin farklılık gösterip göstermediği incelendi. Yöntem: Bu çalışmaya Ankara Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi Psikiyatri Bölümüne poliklinikten başvuran hastalardan DSM-IV tanı ölçütlerine göre OKB tanısı almış 61 hasta ve kontrol grubu olarak da hastane personelinden benzer sosyodemografik özelliklerde seçilmiş 30 sağlıklı birey alınmıştır. Bu kişilere Sosyodemografik Veri Formu verilmiş; SCID–I, SCID-II, Üstbiliş Ölçeği (ÜBÖ-30) ve Yale-Brown Obsesyon Kompülsiyon Ölçeği (Y-BOCS) uygulanmıştır. Bulgular: OKB ve sağlıklı kontrol grubu karşılaştırıldığında “Olumlu İnançlar” alt ölçeği hariç diğer ÜBÖ-30 alt ölçekleri ve toplam puan ortalamalarında iki grup arasında istatistiksel olarak anlamlı fark saptanmıştır (p 0.05). Otojen ve reaktif alt tiplerinde üstbilişler karşılaştırıldığında istatistiksel olarak anlamlı bir fark gözlenmemiştir (p 0.05). Sonuç: OKB alt tiplerinde benzer üstbilişsel patolojilerin bulunuşu ve sağlıklı kişilerden farklı oluşu Üstbilişsel Terapinin OKB alt tip ayrımı gözetmeksizin bu alanda bir tedavi seçeneği olabileceği düşüncesini desteklemektedir. Bunun yanı sıra ÜBÖ-30 olumlu inançlar alt ölçeğinde normal sağlıklı grup ile OKB grubu arasında fark olmaması, aydınlatılması gereken noktalarda biridir. Bunun için OKB’da üstbiliş alanında daha fazla çalışmaya ihtiyaç vardır

Dimensional Approach to Obsessive-Compulsive Disorder: Dimensional Obsessive-Compulsive Scale with Turkish Psychometric Properties

Amaç: Boyutsal Obsesyon Kompülsiyon Ölçeği (BOKÖ) obsesif kom-pülsif bozukluktaki (OKB) farklı belirti kümelerinin belirti şiddetlerini ölçen bir değerlendirme aracıdır. Bu çalışma kapsamında BOKÖ’nün Türkçe formunun psikometrik özellikleri değerlendirilmiştir. Yöntem: Hastanemiz, Dışkapı Yıldırım Beyazıt Psikiyatri Poliklinikle-rine ardışık olarak başvuran ve DSM-IV-TR tanı ölçütlerine göre OKB tanısı alan 96 kişi çalışmaya alınmıştır. Katılımcılara Boyutsal Obsesyon Kompülsiyon Ölçeği (BOKÖ), Yale-Brown Obsesyon Kompülsiyon Ölçeği (YBOKÖ), Padua Envanteri (PE) verilmiştir. Ölçek iç tutarlı-lığı için Cronbach Alfa katsayısı ve madde toplam bağıntı katsayılarına bakılmıştır. Faktör yapısını değerlendirmek için temel bileşenler analizi yapılmıştır. Bulgular: Ölçeğin iç tutarlılığını gösteren Cronbach Alfa değeri tüm öl-çek için 0,874’tü. Açıklayıcı faktör analizi sonuçları 4 faktörlü bir çözüm ortaya koymuştur: “bulaş”, “sorumluluk”, “kabul edilemez düşünceler”, “simetri” (cronbach alfa değerleri sırayla; 0,932, 0,933, 0,948, 0,921). BOKÖ toplam puanının; YBOKÖ, PE toplam puanı ve alt ölçek pu-anlarının her biri ile yüksek düzeyde bağıntılı olduğu tespit edilmiştir. Sonuç: Ölçek iç tutarlılık istatistiklerine bakıldığında tüm ölçek için iyi, alt ölçeklerin hepsi için mükemmel tutarlılık istatistikleri tespit edilmiş-tir. Ölçeğin faktör yapısı orijinalinde önerilen 4 faktörlü yapı ile tam bir uyum göstermiştir. Benzer ölçek ve alt ölçeklerle olan ilişkisi ölçek mad-delerinin iddia ettikleri yapıları değerlendirebildiğini düşündürmüştür. Şu haliyle BOKÖ’nün Türkçe sürümünün boyutsal OKB belirtilerini değerlendirmede etkin bir şekilde kullanılabileceği tespit edilmiştir.Objective: The Dimensional Obsessive Compulsive Scale (DOCS) is a measurement tool that examines the severity of thematically dis-tinct symptom domains of obsessive compulsive disorder (OCD). In this study we assess psychometric properties of the Turkish version of DOCS. Methods: Ninety six patients who presented consecutively to the Dışkapı Yıldırım Beyazıt outpatient unit and who were diagnosed with OCD according to the DSM-IV-TR criteria were enrolled in the study. The DOCS, Yale-Brown Obsessive Compulsive Scale (YBOCS), and Padua Inventory (PI) were completed by the participants. Internal con-sistency was estimated using Cronbach’s Alpha values and item-total correlations. Principal component analyses with Varimax rotation were used to assess latent factor structure . Results: Explanatory Factor Analyses (EFA) revealed a 4-factor solution for the DOCS. Chronbach’s alpha values for the whole scale, “contami-nation” sub-scale, “responsibility” sub-scale, “unacceptable thoughts”, and “symmetry” sub-scales were 0,874, 0,932, 0,933, 0,948, 0,921, re-spectively. There was a high correlation between It has been determined that there is high correlations between both total scores and sub-scales scores of DOCS, YBOCS and PI. Conclusions: Internal consistencies were high good for the total scale and very high perfect for the sub-scales. The factor structure and the contents of the factors were perfectly in line with the original scale (i.e. 4 factor). Positive correlations between DOCS, its sub-scales, and similar OCD scales suggest that the DOCS accurately measures the structures it claims to assess. Thus the DOCS Turkish version can measure di-mensional obsessive compulsive symptoms among the Turkish speaking OCD population

Obsesif Kompulsif Bozukluk Tanılı Ergenlerin ve Annelerin Obsesif İnançları ve Çıkarımsal Karmaşaları Arasındaki İlişki

Amaç: Obsesif kompulsif bozukluk(OKB) tanılı ergenlerin ve annelerinin obsesif inançları ve çıkarımsal karmaşaları arasındaki ilişkiyi saptayarak OKB’deki bilişsel değerlendirmeleri araştırmaktır. Gereç ve Yöntem: Çalışmaya 25 OKB hastası (20 erkek ve 5 kız) ile bu hastaların anneleri dahil edildi. Hastalara Okul Çağı Çocukları İçin Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi-Şimdi ve Yaşam Boyu Şekli (K-SADS-PL) ve Yale-Brown Obsesyon-Kompulsiyon Ölçeği (Y-BOKÖ) uygulandıktan sonra OKB tanısı alan hastalara ve onların annelerine Obsesif İnançlar Ölçeği-44 (OİÖ-44), Çıkarımsal Karmaşa Ölçeği (ÇKÖ), Padua Envanteri (PE) uygulanmıştır. Hastaların ve annelerinin obsesif inançları, çıkarımsal karmaşaları ile obsesif kompulsif belirti puanlarının korelasyonu incelenmiştir. Bulgular: Ergenler ile annelerin, obsesif inançları ve çıkarımsal karmaşa ölçeği arasında yapılan korelasyon analizlerine göre sadece ergenlerin obsesif inançlardan mükemmeliyetçilik/kesinlik puanları ile annelerin abartılmış sorumluluk/tehlike puanları arasında istatistiksel olarak negatif yönde anlamlı korelasyon bulundu(r = -0.42, p = 0.039). Sonuç: Bu çalışma OKB tanılı ergenlerdeki obsesif inançlar ve çıkarımsal karmaşa ile ilgili hipotezlerini kısmen destekler. Klinik tedaviler ailelerdeki olası patolojik bilişsel faktörler göz önüne alınarak düzenlenmesi tedavi başarısını artırabilir