Seasonal symptom variation in patients with chronic fatigue: Comparison with major mood disorders

The psychobiology of idiopathic fatigue has received renewed interest in the medical literature in recent years. In order to examine the relation between chronic, idiopathic fatigue and specific subtypes of depressive illness, we characterized the pattern and severity of seasonal symptom variation in 73 patients with chronic, idiopathic fatigue, compared to patients with major depression (n = 55), a typical depression (n = 35), and seasonal affective disorder (n = 16). Fifty of the fatigued subjects also met the specific Centers for Disease Control and Prevention case criteria for chronic fatigue syndrome, though this definition was unable to discriminate a distinct subgroup of patients, based on their seasonality scores alone. As a group, the fatigued subjects reported the lowest levels of symptom seasonality of any of the study groups. Further, even in those fatigued subjects with scores in the range of those seen in patients with seasonal affective disorder, seasonality was not reported to be a subjectively distressing problem. These findings lend support to the idea that although chronic fatigue shares some clinical features with certain mood disorders, they are not the same illnesses. These data are also consistent with the emerging view that chronic fatigue represents a heterogeneously determined clinical condition.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/31850/1/0000799.pd

Dissociative identity disorder presenting as hysterical psychosis

p. 244-252Dissociative identity disorder (DID), formerly known as multiple personality disorder (MPD), usually presents with associated symptoms rather than with the main features of the disorder. It is necessary for the clinician to keep it in mind as a diagnostic probability and to know its various presentations and associated symptoms in order to recognize it. We observed during long-term evaluation of four cases of hysterical psychosis (HP), that they had DID with long-term histories of dissociative symptoms. Patients applying for care who manifest a single dissociative symptom, a dissociative disorder, a severe acute dissociative syndrome with regressive features, or a dramatic and therapy-resistant conversion symptom should be evaluated for other dissociative symptoms and especially for their chronicity. In our experience, one presenting form of dissociative identity disorder is a hysterical psychosis, a type of crisis situation in the context of the longitudinal course of the dissociative identity disorder

Quetiapine Dependence and Withdrawal: A Case Report

Quetiapine is a new-generation antipsychotic medication approved in the treatment of schizophrenia, bipolar disorder, and related disorders. There are reports about the abuse and possible dependence of quetiapine. We present the first case of definite quetiapine dependence. This is a 37-year-old male who applied to the addiction unit because he could not control quetiapine use. He had a history of alcohol and benzodiazepine dependence as well as cannabis abuse. He reported to have a rush on quetiapine and suffered from its withdrawal when he tried to wean off the medication. This case and similar other suggest that while quetiapine may be beneficial in the treatment of some patients with addictive disorders, we should be cautious when using quetiapine to treat patients with drug or alcohol dependence

Depression, Anxiety Disorders, Quality of Life and Stress Coping Strategies in Hemodialysis and Continuous Ambulatory Peritoneal Dialysis Patients

Objective: In this study, we aimed to assess patients with chronic kidney disease on hemodialysis or continuous ambulatory peritoneal dialysis (CAPD) and to compare them with matched controls for depression, anxiety disorders, quality of life, and stress coping strategies and to estimate the comorbidity of psychiatric disorders and related risk factors

The Relationship Between Substance Abuse Treatment Completion, Sociodemographics, Substance Use Characteristics, and Criminal History

The purpose of this study is to determine if a significant relationship exists between the sociodemographics, substance use characteristics, criminal history, and completion of substance abuse treatment. In this study, 115 individuals being monitored for substance abuse treatment on probation at the Probation and Help Center under the Republic of Turkey's Ministry of Justice's Chief Public Prosecutor's Office of Istanbul were included successively between the dates of April 2008 and April 2009. During a 24-week follow-up, individuals whose urine analyses were clean 6 times consecutively were considered to have completed the treatment successfully. To determine the effect of sociodemographic factors and substance use characteristics on treatment completion, a semistructured sociodemographic data survey was used. Also, the participants' criminal records were examined. Atotal of 115 people participated in the study. One hundred ten (95.7%) of them were male. Sixty-eight (59.1%) of the participants had completed treatment. Age group, education level, age of onset for substance use, number of substances used, employment status, and criminal records showed a significant difference between treatment completers and noncompleters. When a logistic regression analysis was done, only number of substances used and criminal record (other than drug possession) were significantly different for the 2 groups. The current treatment program for polysubstance users and individuals with a criminal record is insufficient. It is necessary that treatment systems be developed so they can be beneficial for these types of patients

Reliability and validity of the Turkish version of the dissociative experiences scale

p. 010-013The dissociative experiences scale (DES) is a 28-item self-rating questionnaire measuring dissociation. It is a reliable and valid instrument that is able to distinguish between subjects with a dissociative disorder and those without. It is also a screening test for major dissociative psychopathology in normal and clinical populations. In order to test its validity and reliability, a Turkish version of DES was administered to 25 patients with multiple personality disorder, 23 patients with schizophrenic disorder, 21 patients with bipolar affective disorder, 26 patients with obsessive compulsive disorder and 671 subjects as a non-psychiatric control group. The Turkish version of DES has good split-half and test-retest reliability, internal consistency, and criterion-related validity. It is able to differentiate between subjects with and without chronic, complex dissociative disorders

Weber Syndrome secondary to synthetic cannabinoid use

Synthetic cannabinoid abuse may lead to physical and psychological disorders. This substance has disseminated rapidly in recent years and the literature about its bad consequences is rather sparse. In this study, we aimed to introduce a patient who present with mesencephalon infarctus (Weber Syndrome) after using synthetic cannabinoid

Predictive Factors for Treatment Success in the Early Period of Buprenorphine/Naloxone Maintenance Treatment for Opiate Addiction

The aim of this study is to determine the factors that influence the treatment response and to contribute to the development of treatment protocols that are specific to our society. This study was conducted on 50 patients who were diagnosed with opiate addiction in the Istanbul Faculty of Medicine, Department of Psychiatry, Istanbul University. They were first interviewed at the inpatient ward during detoxification and were followed up monthly at the Addiction Outpatient Unit after discharge. During the first and the forth interview (at the end of the third month) the Addiction Severity Index (ASI), the Zuckerman-Kuhlman Personality Questionnaire, the Levenson Psychopathy Scale, the Addiction Treatment Success Factors Predicting Scale, the Visual Analog Scale, and the Perceived Stress Scale were administered. During the interviews at the first, second, and third months after discharge, the Visual Analog Scale was administered. At each visit, a urine sample was collected from the patients in order to screen for opiates, cocaine, cannabis, benzodiazepines, and amphetamines. The patients with a positive urine test result for any substance were excluded from the follow up. A total of 50 opiate addicted patients were included in the study, 82% (n = 41) of them were males, 18% (n = 9) were females, and their ages were between 20 and 69 years. We found that age, educational level, gender, type of substance use, perceived stress, medical condition, business-support status, drug and alcohol use, legal status, family and social relationships, psychiatric condition, craving, personality traits, psychopathy, and social and environmental factors did not have predictive value for short term treatment success among patients with opiate addiction

Severe mental disorders, depression and smoking cessation

In recent years, large campaigns have been organized for smoking cessation, health professionals have been educated about this topic and special treatment programs have been developed by the government for smokers. Although cigarette smoking is very frequent among patients with severe mental illness and it's a cause of morbidity and mortality, psychiatrists are not very eager for smoking cessation among psychiatric patients. However, in recent years, treatment studies have shown that with some modifications, conventional smoking cessation approaches may be quite beneficial among these severe mentally ill patients who are classically known to be failures in such treatments. In recent years, there have been developments in pharmacological approaches for smoking cessation, but neuropsychiatric side effects of these medications may be serious. Risk and benefit ratio for each patient should be taken into account while making a treatment plan

Predictive Factors for Treatment Success in the Early Period of Buprenorphine/Naloxone Maintenance Treatment for Opiate Addiction

The aim of this study is to determine the factors that influence the treatment response and to contribute to the development of treatment protocols that are specific to our society. This study was conducted on 50 patients who were diagnosed with opiate addiction in the Istanbul Faculty of Medicine, Department of Psychiatry, Istanbul University. They were first interviewed at the inpatient ward during detoxification and were followed up monthly at the Addiction Outpatient Unit after discharge. During the first and the forth interview (at the end of the third month) the Addiction Severity Index (ASI), the Zuckerman-Kuhlman Personality Questionnaire, the Levenson Psychopathy Scale, the Addiction Treatment Success Factors Predicting Scale, the Visual Analog Scale, and the Perceived Stress Scale were administered. During the interviews at the first, second, and third months after discharge, the Visual Analog Scale was administered. At each visit, a urine sample was collected from the patients in order to screen for opiates, cocaine, cannabis, benzodiazepines, and amphetamines. The patients with a positive urine test result for any substance were excluded from the follow up. A total of 50 opiate addicted patients were included in the study, 82% (n = 41) of them were males, 18% (n = 9) were females, and their ages were between 20 and 69 years. We found that age, educational level, gender, type of substance use, perceived stress, medical condition, business-support status, drug and alcohol use, legal status, family and social relationships, psychiatric condition, craving, personality traits, psychopathy, and social and environmental factors did not have predictive value for short term treatment success among patients with opiate addiction