What Is The Avoidant/Restricted Food Intake Disorder? Diagnosis And Treatment Approaches

2013 yılında yayınlanan DSM-5'te yeni birçok bozukluk tanımlanmıştır. Bunlardan biri de Kaçıngan/kısıtlı yiyecek alımı bozukluğudur (KKYAB). Bu yeme bozukluğuna belirgin yeme kısıtlaması ve gelişme geriliği eşlik etmesine rağmen kilo alma korkusu eşlik etmemektedir. Bundan dolayı anoreksiya nervoza ve bulumia nervozadan ayrı bir tanı olarak sınıflanmasına karar verilmiştir. Çocuklarda, yetişkinlerde ve yaşlılarda KKYAB epidemiyolojisi için daha fazla çalışmaya ihtiyaç duyulmaktadır. Toplum örnekleminde yaklaşık %3 ve klinik örneklemlerde %14–23 arasında görüldüğü bilinmektedir. Ayrıca, tanı sınıflandırmalarında henüz yeni yer alan KKYAB etiyolojisine ilişkin de henüz yeterli veri bulunmadığı tespit edilmiştir. Birinci basamak sağlık hizmeti sunucularının, erken tanı ve sekelleri en aza indirmeleri ve uygun müdahalelerde bulunabilmeleri için KKYAB ve bunun çeşitli klinik görünümlerinin farkında olmaları gerekir. Tedaviye umut veren yaklaşımlar, Bilişsel davranışçı terapi (BDT) ve aile temelli tedaviye (ATT) yönelik modifikasyonları içerir. Bu derlemedeki amacımız KKYAB'in tarihsel gelişimi, tanı kriterleri, kliniğini ve tedavisini güncel literatür ışığında gözden geçirmektir.Many new disorders have been identified in the DSM-5 published in 2013. One of them is avoidant/restricted food intake disorder (ARFID). Although this eating disorder was accompanied by significant eating restriction and growth retardation, it is not accompanied by fear of weight gain. Therefore, it was decided to be classified as a separate diagnosis from anorexia nervosa and bulumia nervosa. More studies are needed for the epidemiology of ARFID in children, adults and the elderly. It is known to be seen approximately 3% in the community sample and between 14% and 23% in clinical samples. In addition, it has been found that there is not yet sufficient data on the etiology of ARFID which is yet to be included in diagnostic classifications. Primary health care providers should be aware of ARFID and its various clinical manifestations for early diagnosis, minimizing sequelae and making appropriate interventions. Approaches which promise hope to treatment include modifications to cognitive behavioural therapy (CBT) and family based therapy (FBT). Our purpose in this review is to review the historical development, diagnostic criteria, clinic features and treatment of ARFID in the light of current literature

Reliability and validity of a Turkish version of the acceptance and action diabetes questionnaire

WOS: 000472919500002PubMed ID: 31247700Objective The aim of this study is to perform validity and reliability examination of the Turkish form of Acceptance and Action Diabetes Questionnaire, and to investigate whether this scale is a measurement tool for evaluation of psychological flexibility levels in a sample of patients with diabetes in Turkey. Methods This study was conducted with 105 patients. Turkish forms of the Beck Depression Inventory (BDI), Problem Areas in Diabetes Questionnaire (PAID), State-Trait Anxiety Inventory (STAI-I and STAI-I I), Audit of Diabetes-Dependent Quality of Life (ADDQoL) and Turkish form of Acceptance and Action Diabetes Questionnaire (TAADQ) were applied. SPSS 20.0 and AMOS was used in statistical analysis. Results 56.12% of the patients were female and the mean of age was 54 (SD=+/- 9.9) years. The mean duration of education was found 7.65 (SD=3.97) years. 74.8% of the patients most of whom (83.3%, n=85) had diabetes mellitus and the mean glycemic control calculated with HbAlc was 8.02 +/- 1.91. According to the final fit indices, we found that the revised and corrected 9-item model was superior over the previous model. Cronbach Alpha coefficient of TAADQ was found as 0.836. Conclusion TAAI)Q is a valid and reliable assessment tool in Turkish population. So TAADQ will be a powerfull tool in assessing psychological flexibility in diabetes patients

Companson of personality beliefs between depressed patients and healthy controls

Introduction: According to the cognitive model, the common mechanism underlying all psychological disorders is distorted or dysfunctional thoughts that affect mood and behaviors. Dysfunctional thoughts predispose an individual to depression and are among the processes that form the basis of personality traits. Elucidating the personality beliefs associated with depression and dysfunctional thoughts is important to understanding and treating depression. The aim of the present study is to determine whether depressed patients exhibited pathological personality beliefs compared with healthy controls. Furthermore, we investigated which personality beliefs were more common among such depressed patients. Methods: A total of 70 patients who were admitted to the Department of Psychiatry at Ankara Diskapi Yildirim Beyazit Training and Research Hospital (Ankara, Turkey) and diagnosed with major depressive disorder according to The Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) diagnostic criteria were included in the study. Additionally, 70 healthy controls matched for age, marital status, and education were included in the study. The Sociodemographic Data Form and Personality Belief Questionnaire-Short form (PBQ-SF) were administered to the participants. Results: A comparison of the depression group with the healthy controls revealed higher scores in dependent, passive aggressive, obsessive compulsive, antisocial, histrionic, paranoid, borderline, and avoidant personality subscales in the depressive group. Conclusions: These results suggest that personality beliefs at the pathological level are more common in depressive patients and that the detection of these beliefs would be useful for predicting the prognosis of the disease and determining appropriate treatment methods. (C) 2014 Elsevier Inc. All rights reserved

The Role of Metacognitive Processes and Emotional Schemas in Obsessive Compulsive Disorder

Objective: This research aims to investigate the relationship between disorder severity and ruminative thinking style, emotional schemas, thought-action fusion and reciprocal interaction of these variables at individuals with obsessive compulsive disorder(OCD). Method: The sample of the study consists of 18 male and 47 female individuals who diagnosed as OCD according to DSM-IV-TR that applied the outpatient clinic of Bakirkoy Research Hospital for Psychiatry and Neurology between September 2014 and April 2014. Sociodemographic form, Yale Brown Obsessive Compulsive Scale (YBOCS), Ruminative Thinking Style Questionnaire (RTSQ), Thought Action Fusion Scale (TAFS) and Leahy Emotional Schema Questionnaire (LESQ) were applied to participants. Data analyzed by using SPSS 20 version. Results: The mean age of participants is 31,80±7,41. According to results determined by using Pearson Correlation Analysis, a significant positive correlation between RTSQ total scores and LESQ weakness against emotions, acceptance of feelings, duration sub-scales, TAFS likelihood sub-scale, YBOCS obsession, YBOCS compulsion and YBOCS total scores was found. Also according to multiple linear regression analysis; its determined that RTSQ total scores predict YBOCS obsession, YBOCS compulsion and YBOCS total scores, TAFS Moral sub-scale total scores predict only YBOCS obsession total scores. Conclusion: It can be suggested that treatment objectives at psychotherapy approaches for OCD should involve ruminative response style and TAF Moral dimension when all the results evaluated together. While emotional schemas dont predict OCD severity directly, emotional schemas can have indirect effects on severity of disorder when the correlation between other scales considered. [JCBPR 2015; 4(3.000): 173-183

Care-giving burden and quality of life in diabetic foot patients' care givers

Introduction: The burden of care-giving is defined as the burden sustained by an individual who is giving care to an elderly, chronically ill or incapacitated person; the levels of perception of the burden are known to be affected by various personal and disease-related characteristics. Studies that compare the burden of internal patients’ caregivers with psychiatric patients’ caregivers, reported higher caregiving burden for caregivers of psychiatric patients. In this study, it was aimed to compare the levels of the caregiving burden of those caring for patients with diabetic foot with care-givers of psychotic patients. Caregivers of those with inguinal hernia were designated as the control group to determine the characteristics that are related to the care-giving burden.   Methods: The study was comprised of care-givers of 30 hospital in-patients with diabetic foot, 30 in-patients with inguinal hernia, and care givers of 30 patients with a recorded diagnosis of psychotic disorder at Çorum Community Mental Health Centre. The evaluation was made from voluntary completion of the Zarit Burden Interview Form and the Beck Depression, Beck Anxiety, Hospital Anxiety and Depression (HAD) and Short Form-36 (SF-36) scales. Results:  The caregivers of the diabetic foot group were found to be mostly non-working females. No difference was found between the burden levels of psychotic and diabetic patient groups but the burden level of caregivers of psychotic patients was determined to be significantly higher than the control group (p lt;0.001). In comparison with those of the control and psychotic group, the depression and anxiety scales of the diabetic foot group were signficantly high and some points of the quality of life scales were determined to be significantly low. A correlation between the duration of care-giving and the burden was only determined in the diabetic foot group (r=0.421, p=0.020). Conclusion: Care-givers of diabetic foot patients remained more socially isolated. This was probably due to having to live with an elderly person requiring care. For various reasons, care-givers of diabetic foot patients were found to have high levels of anxiety and depression, low quality of life, and burden levels as high as those of the psychotic group. Therefore, in the context of protecting the physical and emotional health of care-givers, careful monitoring and when necessary, supportive treatment would be appropriate

Care-giving burden and quality of life in diabetic foot patients' care givers

Introduction: The burden of care-giving is defined as the burden sustained by an individual who is giving care to an elderly, chronically ill or incapacitated person; the levels of perception of the burden are known to be affected by various personal and disease-related characteristics. Studies that compare the burden of internal patients’ caregivers with psychiatric patients’ caregivers, reported higher caregiving burden for caregivers of psychiatric patients. In this study, it was aimed to compare the levels of the caregiving burden of those caring for patients with diabetic foot with care-givers of psychotic patients. Caregivers of those with inguinal hernia were designated as the control group to determine the characteristics that are related to the care-giving burden.   Methods: The study was comprised of care-givers of 30 hospital in-patients with diabetic foot, 30 in-patients with inguinal hernia, and care givers of 30 patients with a recorded diagnosis of psychotic disorder at Çorum Community Mental Health Centre. The evaluation was made from voluntary completion of the Zarit Burden Interview Form and the Beck Depression, Beck Anxiety, Hospital Anxiety and Depression (HAD) and Short Form-36 (SF-36) scales. Results:  The caregivers of the diabetic foot group were found to be mostly non-working females. No difference was found between the burden levels of psychotic and diabetic patient groups but the burden level of caregivers of psychotic patients was determined to be significantly higher than the control group (p<0.001). In comparison with those of the control and psychotic group, the depression and anxiety scales of the diabetic foot group were signficantly high and some points of the quality of life scales were determined to be significantly low. A correlation between the duration of care-giving and the burden was only determined in the diabetic foot group (r=0.421, p=0.020). Conclusion: Care-givers of diabetic foot patients remained more socially isolated. This was probably due to having to live with an elderly person requiring care. For various reasons, care-givers of diabetic foot patients were found to have high levels of anxiety and depression, low quality of life, and burden levels as high as those of the psychotic group. Therefore, in the context of protecting the physical and emotional health of care-givers, careful monitoring and when necessary, supportive treatment would be appropriate

Inductive Reasoning in Patients with Paranoid Type Schizophrenia

The goal of our study is to evaluate the decision making and reasoning of the paranoid type schizophrenic patients, and their confidence in reasoning and perseverance in keeping to their decisions via using Reasoning with Inductive Argument Test (RIAT). Thirty-two delusional patients and 30 healthy volunteers were included in the study. After the diagnostic interview was conducted by SCID-I to the patients who were asked to participate in the study, RIAT test was applied by the interviewer in order to detect the inferential thinking patterns. Apart for the 3rd item out of 11 RIAT items the difference of initial scores are not statistically significant. After both delusional patient group and control groups RIAT items are read, according to ANOVA results of the difference between the belief levels in the result of their initial reasoning and belief level after seeing the alternatives (RIAT belief level before and after), no significant differences were detected for both groups in terms of changes between the belief levels to the RIAT items before and after. According to this study apart from the area of delusions, it can be say that the reasoning of the patients is normal. Our study indicates that when the delusional patients are compared to the control group in terms of jumping to conclusion and modifying their initial beliefs, they are not different when given similarly sufficient amount of data. [JCBPR 2017; 6(2.000): 67-74

The efficacy of cognitive behavioral group therapy in women with obesity antidepressant treatment

Objective: We aimed to investigate the effects of a structured cognitive behavioral group therapy (CBGT) on weight loss, depression, anxiety, body image and self-esteem levels in women with obesity treatment and to show that cognitive behavioral therapy may also be effective in the treatment of obese women receiving antidepressant medication in our study. Methods: Fourteen sessions of CBGT were administered to 28 obese female patients who met inclusion criteria. Measurement and clinical scale application were made before and after the therapy. Six months after the therapy, the patients were asked about their weight by phone call. Sociodemographic Information Form, body mass index (BMI) monitoring, DSM-IV based Structured Clinical Interview, State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), Short Form-36 (SF-36), and Symptom Check List-90 (SCL-90) were applied to the cases. Results: A statistically significant decrease in patients' weight and body mass index were found after 14 sessions of therapy (p<0,001). Statistically significant difference were found about the BDI (p=0,009), TAI (p=0,020), SCL-90 (p=0,001), SF-36 physical function (p=0.035), SF-36 general health (p=0.004), SF-36 social function (p=0.034) scores between the beginning and the end of the therapy. There was no statistically significant difference between the measurements of BMIs at the end of therapy and at the end of therapy. Conclusion: We can say that the method we applied with the findings obtained works. According to this, CBGT is a suitable treatment method for obese people in controlling BMI, providing psychological well-being and improving quality of life

Reasoning with Inductive Argument Test: A Study of Validity and Reliability

Objective: The aim of our study is to research reliability and validity and to evaluate the usability of Turkish version of Reasoning with Inductive Argument Test (RIAT) in Turkish healty population. Method: 51 healty volunteers who work in Ankara D&yacute;skapi Yildirim Beyazit Research and Training Hospital participated in this study. Reasoning with Inductive Argument Test (RIAT) was translated into Turkish by three clinical good knowledge of English. Participants were given a sociodemographic data form, and RIAT were performed by clinicians. To test the reliability of the Turkish version of RIAT, Cronbach&#146;s alpha coefficient was calculated and the halving method was used for the test. Results: The internal consistency of the Reasoning with Inductive Argument Test (RIAT) items, Cronbach&#146;s alpha internal consistency coefficient measurements of 0.73 was found to be statistically significant. Spearman-Brown coefficient that determines the reliability of the whole test r=0.74 was found. Kurtosis values of all the items was below 1.5 and the percentages in the second evaluation were mainly lower. At the same time, both change in belief between self produced RIAT options and given RIAT options (p=0.02, z=-2296) as well as changes in beliefs between related and unrelated items for Obsessive Compulsive Disorder (OCD) difference (p=0.03, z=-2.199) were significant. Conclusion: The preliminary data obtained from the study of reliability and validity of the scale shows that &#145;Reasoning with Inductive Argument Test&#146; supports reliability and validity in Turkish population. [JCBPR 2013; 2(3.000): 156-161

The Effectiveness of Cognitive Behavioral Group Psychotherapy For Obsessive-Compulsive Disorder

Objective: The aim of this study was to determine the effectiveness of cognitive behavioral group therapy (CBGT) in the treatment of the obsessive-compulsive disorder (OCD). Materials and Methods: The study included 82 patients diagnosed as OCD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). In all, 37 patients that had their diagnosis confirmed via the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and agreed to participate were provided group therapy as 14 weekly 90-120-min sessions. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Yale-Brown Obsessive Compulsive Scale-Symptom Checklist (Y-BOCS-SC), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were administered to the patients prior to group therapy (baseline) and again after sessions 2, 5, 8, 12, and 14. Results: In all, 8 patients dropped out of the study for various reasons and 29 completed the group therapy. There were significant reductions in BAI, BDI, and Y-BOCS scores in the patients that completed the group therapy. Additionally, BM, BDI, and Y-BOCS score did not differ according to age, gender, or level of education. Conclusions: CBGT was associated with significant improvement in OCD symptoms. Neither demographic characteristics (age, gender, and education level), nor clinical characteristics (disease duration, type of obsession, compulsion type, treatment history, and comorbidity pattern) had an effect on treatment outcome. In light of these findings, we think CBGT is an effective option for the treatment of OCD