Duygudurum Dengeleyici Uyum Anketi: Geçerlilik ve Güvenilirlik Çalışması

Amaç: Bu çalışmanın amacı, iki uçlu bozukluk ve duygudurum dengeleyici ilâçlarla ilgili görüş ve inanışları sorgulayan Duygudurum Düzenleyici Uyum Anketinin (DDUA) güvenilirliğini ve geçerliliğini test etmektir. Yöntem: 33 maddeli anket formu, DSM-IV’e göre iki Uçlu Bozukluk tanılı, iyilik dönemindeki 200 hastaya uygulanmıştır. İç tutarlılık cronbach alpha ile test edilmiştir. Yapısal geçerlik için faktör analizi uygulanmıştır. Bulgular: DDUA, doktor-hasta ilişkinin algılanması, duygudurum dengeleyicileri hakkında inançlar, genelde korunmuş özerklik, duygudurum dengeleyicinin dozunu ayarlamada korunmuş özerklik alt boyutlarında iyi ve kabul edilebilir bir iç tutarlılığa sâhiptir ve faktör analizi 4 alt boyutu işaret etmektedir. Tartışma ve Sonuç: DDUA olumlu psikometrik özelliklere sâhiptir. Gelecekteki çalışmalar DDUA’nin tedavi uyumundaki öngörücülüğünü araştırmaya yönelik olmalıdır

Attachment and Psychopathology

The type of attachment defined in the early stages of life and thought to be continuous, is a phenomenon that shapes the pattern of how a person makes contact with others. The clinical appearance of every type of attachment is different and each one has prospective and retrospective phenomenological reflections. In all stages of life and in close relationships, it can be observed if a person gets in close contact with someone else and if this relation bears supportive and protective qualities. According to attachment theorists, once it is defined as safe or unsafe during nursing period, it shows little change. Starting from Bowlby’s work, unsafe attachment type is considered as the determining factor of psychopathology in the later periods of life, while safe attachment is considered as in relation with healthy processes. The nature’s original model is safe attachment. Anxious/indecisive attachment, an unsafe attachment type, is associated with anxiety disorders and depressive disorder, while avoidant attachment is associated with behavior disorder and other extroverted pathologies. Disorganized/disoriented attachment is considered to be together with dissociative disorder. The aim of this paper is to review attachment theory and the relation between attachment and psychopathology

Synthetic Cannabis-Induced Mania

Synthetic cannabinoids (SC), cannabinoid 1 and cannabinoid 2 receptors agonists, are the psychoactive substances. SC was originally produced to treat medical conditions. Compared to other narcotics, SC is easier to obtain, cheap, and highly potent and has a long half-life. In addition, routine analysis does not detect SC, which has led to widespread use. A case is presented that manic episode was developed with the use of SC. Hospitalization and admission to psychiatric units depending on SC use have been observed mostly with psychosis. Although SC-induced affective symptoms were mentioned in the literature, mania has not been reported before. We aimed to discuss the psychiatric conditions induced by widespread use of SC via our case

Validity-Reliability of Nine Types Temperament Scale Adolescent Form (NTTS-A) and Relationship Between Temperament Types and Attention Deficit Hyperactivity Disorder

The purpose of this study is developing adolescent form (11-16 years old) of Nine Types Temperament Scale (NTTS) depending on Nine Types Temperament Model (Study 1) and evaluating and searching the relationship between Attention Deficit and Hyperactivity Disorder (ADHD) and Types of NTTM (Study 2). Sample of Study I consist of 1240 students who are between 11 and 16 years old. Pilot form of the Scale which consists of 90 items is tested with confirmatory factor analysis and with convergent and discriminant validity and the last version of the measure which consist of 82 items is prepared. Basic Personality Traits Inventory (BPTI) which depends on Fife Factor Model is used for Criterion-related validation. Results show that NTTS-A is valid and reliable measure for evaluating temperament types between 11-16 years adolescents. Their fit index is calculated as chi(2) /df <3; SRMR, 0.06; RMSEA, 0.045; CFI, 0.909: TLI, 0901 supported to validity data. Sample of Study II consist of 56 adolescents who are diagnosed with ADHD according to DSM-IV diagnosis criteria and 56 students who does not get diagnosed with ADHD or mental retardation/medical disorder. Temperament types of participants are evaluated by the agency of Study-I and NTTS-A, which is developed appropriate for Turkish culture. Indication of the study shows that there are more NTT7 and NTT8 in NTTM types between adolescents with ADHD than the group, who are not diagnosed with ADHD. As a result, it is discussed that traits which belong to some temperament types could have a predisposing effect on emergence of ADHD, experiencing these traits extreme severely could cause a view similar to ADHD and ADHD which is a neurodevelopmental disease could interact with temperament traits of person, in that way it could illustrate ADHD clinic. Available findings support critics about that students are labelled as ADHD specially in the last years in education environment even if they have mostly not developmental problems and students are diagnosed easily with limited observations. However, it is asserted that diagnosis based on temperament, treatment and psychosocial support programmes could be formed and effects of ADHD, which is a factor interacting with temperament traits, on personality structure of adolescents on their development process, could be predicted. Our study has the feature of being the first measure developing study which is intended to evaluate temperament types of adolescents between 11-16 years old and also it is has the feature of being the first study which searches relationship between NTTM types and ADHD

Total oxidant–antioxidant and paraoxonase-1 levels in premenstrual dysphoric disorder: a follow-up study

Objective: Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual syndrome (PMS) that was categorized as a mood disorder in the most recent version of the Diagnostic and Statistical Manual for Mental Disorders. In addition to a history of PMS, a PMDD diagnosis requires prospective symptom assessment for 2 consecutive menstrual periods. Although the effects of some oxidants–antioxidants were previously studied in PMS, their possible effects in PMDD remain unknown. Paraoxonase-1 (PON-1) is a new high-density lipoprotein-associated enzyme with many antioxidative effects. We hypothesized that assessing serum total oxidant–antioxidant and PON-1 levels could clarify the role of oxidant–antioxidant system in PMDD. Methods: All participants (n = 50) were assessed by an experienced psychiatrist for PMDD by using the Diagnostic and Statistical Manual for Mental Disorders-IV (DSM-IV), Premenstrual Assessment Form and Daily Record of Severity of Problems (DRSP)-Short Form or possible psychiatric disorders including depression, anxiety, and sleep disorders. Serum estrogen, progesterone, total oxidant–antioxidant, and paraoxonase-1 (PON-1) levels were measured in the serum of 20 participants with PMDD and 30 asymptomatic controls during the follicular and luteal phases of two consecutive menstrual cycles. Sleep quality, depression, and anxiety symptoms were assessed with the Pittsburg Sleep Quality Index (PSQI), Hamilton Depression Rating Scale (HDRS), and Hamilton Anxiety Rating Scale (HARS), respectively. Results: There were no significant intergroup differences in estrogen, progesterone, oxidant–antioxidant, or PON-1 levels or PSQI scores. However, the mean HDRS and HARS scores were statistically significantly higher for patients with PMDD than for controls. Levels of estrogen, progesterone, and total oxidant–antioxidant were not correlated with HDRS, HARS, or PSQI scores. Conclusions: Considering the lack of differences in hormonal and biochemical levels between the two groups, it may be more efficient and discriminative to longitudinally assess biochemical and cellular stress-related parameters in subjects with PMDD

Once-monthly continuous erythropoietin receptor activator (CERA) for haemoglobin maintenance in haemodialysis patients with chronic renal anaemia

BACKGROUND: This study was conducted to evaluate the efficacy and safety of once-monthly continuous erythropoietin receptor activator (CERA) for maintenance of stable haemoglobin (Hb) levels in adult chronic renal anaemia patients on dialysis according to local clinical judgment in Turkey. METHODS: This was a prospective, open-label, single-arm, multi-centre study conducted in 20 centres in Turkey. After a 4-week screening period, eligible patients receiving conventional erythropoiesis-stimulating agents were converted to monthly intravenous CERA and entered a 16-week CERA dose-titration period (DTP) followed by an 8-week efficacy evaluation period (EEP) and a 4-week safety follow-up. The primary endpoint was the proportion of patients whose Hb concentration remained stable within ±1.0 g/dL of their reference Hb and within the range of 10.0–12.0 g/dL during the EEP. RESULTS: A total of 173 patients were screened, 132 entered the DTP and 84 completed the study. Thirty-nine patients [46.4% (95% confidence interval: 35.5–57.7%)] maintained stable target Hb concentrations. The mean change in time-adjusted average Hb concentration was 0.29 ± 1.08 g/dL between baseline and the EEP. The mean CERA monthly dose was 112.4 ± 76.78 µg during the EEP, and the CERA dose was adjusted in 39 patients (36.4%). Eleven patients (8.4%) reported 13 treatment-related adverse events, the most frequent adverse events being infections and infestations, gastrointestinal and vascular disorders. CONCLUSIONS: Once-monthly CERA maintains stable Hb concentrations in chronic renal anaemia patients on dialysis in Turkey. The study results confirm the known efficacy and safety profile of CERA