Intermittent Explosive Disorder

Intermittent explosive disorder is an impulse control disorder characterized by the occurrence of discrete episodes of failure to resist aggressive impulses that result in violent assault or destruction of property. Though the prevalence intermittent explosive disorder has been reported to be relatively rare in frontier studies on the field, it is now common opinion that intermittent explosive disorder is far more common than previously thought especially in clinical psychiatry settings. Etiological studies displayed the role of both psychosocial factors like childhood traumas and biological factors like dysfunctional neurotransmitter systems and genetics. In differential diagnosis of the disorder, disorders involving agression as a symptom such as alcohol and drug intoxication, antisocial and borderline personality disorders, personality changes due to general medical conditions and behavioral disorder should be considered. A combination of pharmacological and psychotherapeutic approaches are suggested in the treatment of the disorder. This article briefly reviews the historical background, diagnostic criteria, epidemiology, etiology and treatment of intermittent explosive disorder

Long-term Treatment in Bipolar Disorder

Although the importance of long-term prophylactic treatment is certain in bipolar disorder, there is stil debate on how to which patients and evaluate the treatment response. Efficacious long-term treatment can reduce morbidity and mortality significantly and improve quality of life of bipolar patients. The concept of ideal response should also be defined very clearly in order to discuss the difficulties of measuring the effectiveness of the prophylactic treatment. The aims of this paper are to determine whether our currently methods and criteria are valid, reliable and sensitive evaluating the efficacy of the treatment response and to briefly inform the clinicians about the drugs used in pharmacologic prophylaxis in accordance with relevant data

A case of late onset compulsive sexual addiction

WOS: 000392965100009Compulsive sexual addiction is a clinical phenomenon which affects approximately 5% to 6% of the population. It has been reported to be more common in men than women, with an estimated ratio of male to female 3: 1. It is common in late adolescence and early adulthood. People with compulsive sexual addiction have frequent intrusive thoughts about sex and difficulty controlling their sexual behavior which can result in numerous problems. This phenomenon has been evaluated as a behavioral addiction and an obsessive-compulsive spectrum disorder. It has been reported to involve frequent comorbidity with anxiety disorders, depression, alcohol, and drug abuse or dependence. It is not possible to determine the normal frequency of sexual behavior. Total sexual activity as the number of orgasms per week is used to define hypersexuality measure. Here, we reported an atypical case in terms of age of onset and gender

Acute psychotic disorder associated with immunosuppressive agent use after renal transplantation: a case report

Kidney transplantation is the best treatment option for end-stage renal disease in appropriate patients. Immunosuppressant agents given in this duration can cause many psychiatric disorders. In this paper, we present a young kidney transplant patient with psychosis constituted delusions about his transplanted kidney after 4 years later from transplantation. He had refused to take his immunosuppressant pills because of psychotic process. In this paper, we wanted to discuss the psychiatric risks of immunosuppressant agents and importance of the psychiatric treatment in this aspect

Bipolar bozukluk ve özkıyım

Amaç: Bipolar bozukluk hastalarında özkıyım girişimiyle ilgili risk faktörleri halen tam olarak bilinmemektedir. Çalışmamız, bu hastalarda özkıyım girişiminin sıklığı, özkıyım şekilleri ve özkıyımla ilişkili klinik özellikleri değerlendirmeyi amaçlamaktadır. Yöntem: Çukurova Üniversitesi Tıp Fakültesi Ruh Sağlığı ve Hastalıkları Anabilim Dalı Bipolar Bozukluk Birimi’ne ayaktan başvuran 122 hasta çalışmaya alınmıştır. Duygudurum Bozukluğu Hasta Kayıt ve İzleme Formu ve DSM- IV Eksen I bozuklukları için Yapılandırılmış Klinik Görüşme Ölçeği (SCID-I) kullanılmıştır. Ölçekler, hastalarla ve hasta yakınlarıyla yapılan görüşmeler ve takip dosyaları ışığında doldurulmuştur. Bulgular: Ayaktan izlenen bipolar bozukluk hastalarında özkıyım girişimi sıklığı %19.7 olarak saptanmıştır. Çalışmamız, özkıyım girişimiyle kadın cinsiyet, hastalığın ciddiyetini gösteren hastalık süresi, tedavisiz hastalık süresi (latans), hastaneye yatış sayısı, geçirilmiş toplam dönem sayısı, depresif dönem sayısı, karma dönem sayısı ve ailede psikiyatrik hastalık öyküsünün olması gibi klinik özellikler arasında anlamlı bir ilişki olduğunu göstermiştir. Sonuç: Çalışmamız, bipolar bozukluk hastalarında özkıyım girişimi sıklığının yüksek olduğunu göstermiştir. Tedavisiz hastalık süresinin azaltılması, duygudurum dönemlerinin önlenmesi, depresif ve karma dönemler sırasında özkıyım riskinin değerlendirilmesi tedavinin ana hedeflerinin başında gelmelidir. Özkıyımla ilgili uyarıcı belirtilerin saptanması bipolar bozukluk hastaları arasında riskli grubun ayırt edilmesine ve özkıyımın önlenmesine yardımcı olabilir.Bipolar disorder and suicide Objective: The risk factors associated with suicidal behaviour in bipolar patients are not clear yet. We aimed to evaluate the frequency of suicide attempt, type of suicide attempt and significant clinical characteristics associated with suicide attempts. Methods: One hundred twenty two consecutive patients, from Bipolar Disorder Unit of Çukurova University, Faculty of Medicine, Department of Psychiatry, are included in this study. Affective Disorders Patient Registry Form" was developed by Bipolar Disorder Unit and SCID-I were used in this study to collect the data. These forms are filled in through interviews with patients and their relative

Eating disorders in bariatric surgery candidates admitted to Haydarpasa Numune Training and Research Hospital

WOS: 000447765300003Objective: Bariatric surgery is used more commonly than recent years among obesity treatment methods. The prevalence of eating disorders and its effect on surgical outcomes in bariatric surgery candidates are frequently discussed. The present study was planned to assess the prevalence of eating disorders in bariatric surgery candidates. Methods: A psychiatrist in routine proce-dure evaluated 108 bariatric surgery patients. Eating disorders diagnosis (binge eating disoder (BED), anorexia nervosa (AN), bulimia nervosa (BN)) were based to Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and night eating syndrome (NES) diagnosis was based to Allison crieterias. Eating Attitudes Test (EAT) and Beck Depression Inventory (BDI) were administered to all participants. Results: The prevalence of any kind of eating disorder (BED, NES or both) was 23.1% (n=25). BED was 11.1% (n=12), NES 5.6% (n=6), both BED and NES 6.5% (n=7). We could not determine any patient with diagnose of AN or BN in our sample. There was no significant difference at Body Mass Index (BMI) between people with eating disorders and without eating disorders. The mean point of BDI score was 13.8 +/- 9.8. The 50% of sample had family history about psychiatric disease. 63.9% of the sample (n=69) had comorbid other medical conditions. Conclusion: Prevalence of eating disorders is substantially high in this group (23.1%). As we exactly not know the effect of eating disorders at surgery success and weight loss, it is important to determine the maladaptive eating behaviors at the beginning of surgery procedure

Self-esteem and quality of life in bariatric surgery candidates

WOS: 000455891800003Objective: The basic aim of this study was to explore the differences between bariatric surgery candidates (BSC) and control group in self-esteem and quality of life. In addition, our secondary aim is to find out the relationship between self-esteem and quality of life in bariatric surgery candidates. Methods: The study involves a group of BSCs screened at Haydarpasa Numune Training and Research Hospital. Sixty-one consecutive BSCs and control group assessed by Short Form-36 (SF-36), Rosenberg Self-Esteem Scale and Beck Depression Inventory (BDI). Control group was constituted from 61 normal-weight employees from the same hospital. Results: BSCs group consisted from 50 women and 11 men. BSCs scored statistically lower on all the SF-36 subscales, BDI and self-esteem scale compared with controls. The rates of having a lifetime psychiatric disorder and having any comorbid medical condition in the BSCs were statistically significantly higher than the control group. Because of regression analysis, mental health subscale score of SF-36 and BDI score were found to have the most effect on self-esteem in BSCs group. Conclusion: Self-esteem and quality of life are interrelated concepts in BSCs. Self-esteem is most commonly associated with mental health and depression levels as expected. Psychiatric follow-up has a great importance in evaluation and treatment of these patients