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

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

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

Dissociative identity disorder: a clinical investigation of 20 cases in Turkey

p. 003-009This study describes the presentation and clinical features of dissociative identity disorder (DID) in Turkey. The first twenty consecutive patients in a dissociative disorders program of a university clinic in Turkey who met the DSM-HI--R criteria for multiple personality disorder (MPD) and DSM-IV criteria for DID were assessed with clinical interviews, a structured evaluation form consisting of 126 items, and the Dissociative Experiences Scale. Eighteen of the patients were women in their twenties. The median number of alternate personalities was four. Eighty five percent of the patients complained severe headache. All of the patients had at least one Schneiderian first-rank symptom. Childhood traumas were reported in 85% of the cases. The mean DES score was 47.2. These results are remarkably similar to findings from North America and Western Europe, suggesting the validity of DID across cultures

The effects of regular exercise on anxiety, depression and quality of life in adult alcohol and drug dependents in addiction treatment

Objective: The purpose of this study was to examine the effects of moderate-intensity aerobic and strength exercises on anxiety, depression, and quality of life of individuals with alcohol and substance addiction disorder during addiction treatment. Methods: This is a quasi-experimental design research. Depression, anxiety and quality of life of participants were assessed at baseline and at the end of the study and compared the difference between exercise and control group. The Bruce Treadmill Test was used to measure the predicted maxVO(2) to examine the changes in aerobic capacity and the four to six repetition submaximal strength test was used to measure the predicted one repetition maximal strength of the participants in the exercise group. Resting heart rate and blood pressure were also monitored. Results: Anxiety scores of exercisers was significantly lower than control group at the end of the study. Depression level of exercisers was also lower than control group but the difference was insignificant. Significant improvement has been found in the physical functioning, general health and vitality scores on subscales of quality of life of exercise group at the end of the study. A significant increase has been found in aerobic capacity and strength in the exercise group after the exercise intervention. Conclusions: This study is one of the first to examine the effects of both moderate-intensity aerobic and strength exercises on anxiety, depression and quality of life in adult alcohol and drug dependents' in addiction treatment in Turkey