Delirium in patients with acute ischemic stroke admitted to the non-intensive stroke unit: Incidence and association between clinical features and inflammatory markers

Background Stroke patients with development of delirium have unfavorable outcomes, higher mortality, longer hospitalizations, and a greater degree of dependence after discharge. Studies suggest that delirium is associated with abnormal immunological responses and a resultant increase in inflammatory markers. Objective Our aim was to determine whether there is an entity relationship between delirium, inflammation and acute ischemic stroke (AIS). Methods Sixty AIS patients admitted to the hospital were consecutively recruited. Delirium was diagnosed with the clinical assessment according to the Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria. Enzyme-linked immunosorbent assay (ELISA) was used to measure serum levels of Interleukin-1 beta (IL-1 beta), Interleukin 18 (IL-18), Tumor Necrosis Factor-alpha (TNF-alpha), Brain-Derived Neurotrophic Factor (BDNF), and Neuron Specific Enolase (NSE) at admission. Results Eleven (18.3%) of 60 patients were diagnosed with delirium, and the majority (n=8, 72.7%) was the hypoactive type. Delirious and non-delirious patients had similar demographic and clinical features. Delirious patients had significantly higher lengths of hospital stay, National Institutes of Health Stroke Scale (NIHSS) at admission and discharge compared to non-delirious patients. In addition, there was no significant statistical difference between delirious and non-delirious patients with AIS in respect of levels of TNF-alpha, IL-1 beta, IL-18, BDNF and NSE. This study suggests that delirium is not scarce in patients with AIS admitted to the non-intensive stroke unit, and that delirium developing after AIS seems not to be associated with serum TNF-alpha, IL-1 beta, IL-18, BDNF and NSE but is associated with length of hospital stay and stroke severity

Psychopharmacological Treatment and Quality of Life in Obsessive Compulsive Disorder

Objective: Obsessive-compulsiv

Predictors of response pharmacotherapy in obsessive compulsive disorder

Obsesif Kompulsif Bozuklukta İlaç Tedavisine Yanıtın Öngörüctilcri Bu çalışmada obsesif kompulsif bozuklukta (OKB) ilaç tedavisine yanıt ile sosyodemografik özellikler, klinik özellikler, eksen I ve II ek tanılan arasındaki ilişkilerin araştırılması amaçlandı. Çalışmaya DSM-IV tanı ölçütlerine göre OKB tanısı konulan 50 hasta alındı. SCID-I / CV (DSM-IV Eksen I Bozuklukları İçin Yapılandırılmış Klinik Görüşme / Klinik Versiyon), SC1D-1I (DSM-III-R Kişilik Bozuklukları İçin Yapılandırılmış Klinik Görüşme)ve Yale-Brown Obsesyon Kompulsiyon Ölçeği (YBO.KÖ) ile yapılan ilk klinik değerlendirmeden sonra, bütün hastalar esnek dozda fluvoksamin, sertralin veya paroksetin ile 12 haftalık tedaviye alındı. Tedaviye yanıt 12 hafta sonunda YBOKÖ toplam puanlarında en az %35'iik azalma olarak tanımlandı. Çalışmayı 43 hasta tamamladı. Tedaviye yanıt veren hastalarda herhangi bir eksen I bozukluğu, şizotipal kişilik bozukluğu, herhangi bir B kümesi kişilik bozukluğu sıklığı ile YBOKÖ belirti şiddeti ve içgörü skorları tedaviye yanıt vermeyenlere göre anlamlı derecede yüksek bulundu. Lojistik regresyon analizi sonucunda, bu değişkenlerden sadece yüksek YBOKÖ toplam puanının ilaç tedavisine kötü yanıtın bağımsız öngörücüsü olduğu görüldü. Bulgularımız obsesif kompulsif belirtilerin şiddetli oluşunun OKB'li hastalarda ilaç tedavisine yanıtı olumsuz etkilediğini ve tedaviye kötü yanıtın öngörücüsü olduğunu göstermektedir.Predictors of Response io Pharmacotherapy in Obsessive Compulsive Disorder In this study, we aimed to investigate associations between response to pharmacotherapy in obsessive compulsive disorder (OCD) and sociodemographic, clinical characteristics, comorbid axis I and II disorders. Fifty patients with OCD diagnosed according to DSM-IV criteria were included in the study. After initial clinical evaluation with SCID-Î / CV (Structured Clinical Interview for DSM-IV / Clinical Version), SCID-II (Structured Clinical Interview for DSM-III-R Personality Disorders) and Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), all patients underwent a 12-week teratment with flexible-dose fluvoxamine, sertraline or paroxetine. Response to treatment was defined as a decrease at least a 35% on Y-BOCS total scores at the end of 12- week treatment. Forty-three patients completed the study. Nonresponders had a significantly higher frequency of any comorbid axis I disorder, schizotypal personality disorder, any cluster B personality disorder, and higher insight and symptoms severity scores on Y-BOCS. When these variables were entered into logistic regression analyses, it was confirmed that a high Y-BOCS total score to be the independent predictor of poor response to pharmacotherapy. Our findings suggest that the severity of obsessive compulsive symptoms negatively influence response to pharmacotherapy and independent predictor of poor treatment response in patients with OCD

Quality of life in patients with chronic idiopathic urticaria: the impact of Axis I and Axis II psychiatric disorders

Objective: Chronic idiopathic urticaria (CIU) associated with lower quality of life (QoL) levels. Psychiatric disturbances are frequently present in patients with CIU. This study examined the impact of Axis I and Axis II psychiatric disorders oil the QoL of patients with CIU. Method: The study sample consisted of 100 subjects including CIU patients with only Axis I psychiatric diagnoses (n=25), CIU patients with only Axis II diagnoses (n=25), CIU patients with both Axis I and Axis II diagnoses (n=25), CIU patients without any Axis I and Axis II diagnosis (n=25), and healthy control subjects with respect to urticaria and psychiatric disorders (n=25). The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) (SCID-I) and the Structured Clinical Interview for DSM, Revised Third Edition Personality Disorders (SCID-11) was used to determine Axis I and Axis II psychiatric disorders, respectively. QoL levels were assessed by means of the World Health Organization QoL Assessment-Brief (WHOWOL-BREF). Results: There were significant differences among the groups with respect to all WHOQOL-BREF subscale scores. The QoL levels were similar among CIU patients with only Axis I psychiatric diagnoses, CIU patients with only Axis II diagnoses and CIU patients with both Axis I and Axis It diagnoses, and between CIU patients without any Axis I and Axis II diagnosis, and healthy control Subjects. When compared with those of CIU patients without any Axis I and Axis II diagnosis, CIU patients without concurrent psychiatric diagnoses had significantly lower scores in most domains of the QoL scale. Conclusions: Axis I and Axis II psychiatric disorders seem to be considerable factors influencing the QoL in CIU patients. (C) 2008 Elsevier Inc. Ail rights reserved

Pregnancy-onset obsessive-compulsive disorder: clinical features, comorbidity, and associated factors

WOS:000362920300006Objective: The prevalence rate of obsessive-compulsive disorder (OCD) was found to be higher in women during pregnancy and puerperium than that estimated in the general population. Additionally, the symptomatology of OCD shows several variations during the lifetime of women. Objective of the current study was to examine the clinical characteristics and comorbidity with other anxiety and mood disorders of pregnancy-onset obsessive-compulsive disorder (POCD) and to investigate factors related to POCD. Method: The study sample was composed of three groups. The first group (POCD group) included 20 consecutive pregnant women meeting the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) for OCD, showing an onset of OCD during their current pregnancy. The second group (non-OCD group) consisted of 207 consecutive pregnant women without any mood or anxiety disorders to assess factors associated with POCD. In addition, the study included a control group to compare the symptoms of POCD and non-pregnancy-onset OCD. The control group was composed of 40 nonpregnant female outpatients with OCD. Type and severity of obsessive-compulsive symptoms were assessed with the Yale-Brown Obsessive-Compulsive Scale (YBOCS). OCD and other anxiety or mood disorders were determined by means of the Structured Clinical Interview for DSM-IV (SCID-I). Comorbid axis II disorders were diagnosed with the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). Results: The mean onset time of OCD in the POCD group was 13.3±6.35 (week5-28) gestational weeks. OCD occurred during the first trimester of pregnancy in 9 women (45%), during the second trimester in 10 (50%) women, and during the third trimester in 1 (5%) woman. The most common obsessions were contamination (n16, 80%) and symmetry/exactness (n6, 30%), and the most common compulsions were cleaning/ washing (n16, 80%) and checking (n12, 60%) in POCD. Thirteen (65%) of the pregnant OCD patients met the criteria for a mood or anxiety disorder. Generalized anxiety disorder was the most frequently diagnosed axis I disorder (40%, n8). The independent factors associated with POCD were cigarette smoking (p0.002), the existence of an anxiety disorder at onset of pregnancy (p0.000), and obsessive-compulsive personality disorder (p0.003). Conclusion: The present study suggests that POCD presents similar clinical characteristics with nonpregnancy-onset OCD. Mood or anxiety disorder comorbidity is observed in more than half of the women with POCD. Additionally, pregnant women who have at least one of 3 factors (cigarette smoking, the existence of an anxiety disorder at onset of pregnancy, and obsessive-compulsive personality disorder) seem to be at risk for POCD

Postictal physichosis

Postiktal psikoz epileptik hastalarda görülen psikozların % 25'ini oluşturur. Tipik olarak tonik klonik veya kompleks parsiyel nöbet kümeleri sonrası ortaya çıkar. Bilateral bağımsız epileptik aktivite postiktal psikozlu hastalarda sıklıkla görülmektedir. Olguda postiktal psikoz gelişen ve risperidon ile tedavi edilen epileptik bir hasta sunulmuştur.Postictal psychosis represents 25% of the psychoses seen in epileptic patients. PIP typically appears after a cluster of tonicclonic seizures or complex partial seizures. Bilateral independent epileptiform activity has been observed in patients with postictal psychosis. We present the case of a patient who developed postictal psychosis and was treated with risperidon

Postiktal psikoz

epileptik hastalarda görülen psikozların % 25’ini oluşturur. Tipik olarak tonik klonik veya kompleks parsiyel nöbet kümeleri sonrası ortaya çıkar. Bilateral bağımsız epileptik aktivite postiktal psikozlu hastalarda sıklıkla görülmektedir. Olguda postiktal psikoz gelişen ve risperidon ile tedavi edilen epileptik bir hasta sunulmuştu

The levels of depression, anxiety and quality of life in patients with chronic idiopathic urticaria

Background Chronic idiopathic urticaria (CIU) is associated with severely impaired quality of life (QoL)

Antidepressants and menstruation disorders in women: a cross-sectional study in three centers

WOS: 000308511500012PubMed: 22534402Objective: The relationship between menstruation disorders and antidepressant drugs usage in women remains unclear. In this study, we aimed to investigate the incidence rate of antidepressant-related menstruation disorders and to examine whether or not antidepressant use is associated with menstrual disorders in women. Methods: The study sample was gathered from three centers and four hospitals. A total of 1432 women who met the criteria of inclusion were included in the study. The sample was divided into two groups: the antidepressant group (n=793) and the control group (n=639). The menstruation disorders were established with reports from the study participants on the basis of related gynecological descriptions. Results: The prevalence of menstrual disorders was significantly higher in the antidepressant group (24.6%) than the control group (12.2%). The incidence of antidepressant-induced menstruation disorder was 14.5%. The antidepressants most associated with menstrual disorders were paroxetine, venlafaxine, sertraline and their combination with mirtazapine. Overall, the incidence rate was similar in women receiving selective serotonin reuptake inhibitors and serotonin noradrenaline reuptake inhibitors. Conclusions: The results of the present study suggest that menstruation disorders are frequently observed in women taking antidepressants and that it appears to be associated with antidepressant use at least in some women. (C) 2012 Elsevier Inc. All rights reserved