What are the factors that contribute to aggression in patients with co-occurring antisocial personality disorder and substance abuse?

Background: A significant number of individuals with high levels of aggression have substance use disorder problems. Objective: This study aimed to evaluate the effect of substance use disorder on aggression in young men with Antisocial personality disorder (ASPD). Methods: This cross-sectional study included 328 patients and were diagnosed with ASPD with a comorbidity of substance use disorder, along with 111 healthy young male subjects. Results: The total aggression scores of the patients with a diagnosis of ASPD were significantly higher than those of the healthy group (p < 0.001). Mean scores of aggression subscale, except for indirect aggression, were higher in patients diagnosed with ASPD (p < 0.05). There was a positive correlation between aggression scores and total API scores in patients diagnosed with ASPD (p < 0.001). Aggression scores were higher when subjects were using volatile substances compared to other substances (p < 0.05). Aggression scores increased with duration of substance use disorder (p < 0.001). Discussion: Substance use disorder should be treated first to mitigate aggression in individuals with ASPD. Patients with severe addiction to volatile substances should be given treatment priority. Further studies are necessary to determine the cause of aggression in individuals who abuse substances

A Case of Secondary Hypersomnia Associated with Amlodipine

Excessive daytime sleepiness is a symptom which can caused serious problems in patients life and is widely common in general population. It may be occurred depending on drug use and medical conditions. Secondary reasons must be investigated before making the diagnosis of primary hypersomnia in patients with excessive daytime sleepiness. In this case report, a patient who was followed up with the diagnosis of idiopathic hypersomnia, but was diagnosed as hypersomnia associated with amlodipine use along with conditions that Obstructive Sleep Apnea syndrome and delayed sleep phase syndrome may cause excessive daytime sleepiness, was presented

A Case of Pleiosomnia Following Traumatic Brain Injury

Sleep-wake disturbances are highly prevalent and often become persistent sequelae after traumatic brain injury. The most common disturbances are insomnia, excessive daytime sleepiness, and increased sleep need (pleiosomnia). Circadian rhythm sleep-wake disturbances and parasomnias are more rare disturbances. These disorders can affect the treatment process and exacerbate other problems such as cognitive, and psychiatric problems. Among these sleep disturbances, hypersomnia is the most damaging disorder for the patients functionality. In this case report, a patient who was complaining of increased sleep need after traumatic brain injury was presented

Relationship between apnea-hypopnea index and oxygen desaturation in REM-sleep period and morning headache in patients with obstructive sleep apnea syndrome

Introduction: In patients with morning headache, REM sleep period decreases though little is known about its physiopathology. We evaluate the polysomnographic records of obstructive sleep apnea syndrome (OSAS) patients with the hypothesis that oxygen desaturations may be a better determinant in patients with morning headache, especially those in REM sleep periods. Methods: Patient group (group 1) with a total of 361 patients with OSAS and the controls (group 2) with 107 healthy individuals were evaluated. The presence of morning headache was compared between the groups, and sleep parameters were correlated with morning headache. Results: In group 1, patients with OSAS and morning headache, apneahypopnea index in the REM sleep period (26.7/hour, min-max: 0-108.4/hour) was higher than those in patients without morning headache (17.8/hour, min-max: 0-107.8/hour). The minimum oxygen saturation in REM sleep period and total sleep time (TST) was lower in patients with morning headache (REM sleep period: 82%, min-max: 50-94%; TST: 79%, min-max: 50-97%) in compared to patients without morning headache (REM sleep period: 84%, min-max: 50-93%; TST: 81%, min-max: 50-90%). Conclusion: Here we demonstrated that higher apnea-hypopnea index and lower oxygen saturation in REM sleep period were associated with morning headache in patients with obstructive sleep apnea syndrome

Madde Kullanım Bozukluğu Olan Gençlerin Cinsel Yolla Bulaşan Hastalık Bilgi Düzeyleri

Amaç: Bu araştırmada, madde kullanım bozukluğu olan gençlerin cinsel yolla bulaşan hastalık bilgi düzeylerini değerlendirmek amaçlanmıştır.Gereç ve Yöntem: Bu tanımlayıcı araştırma, Konya Asker Hastanesi Psikiyatri Polikliniğinde 07 Nisan–05 Kasım 2015 tarihleri arasında yapılmıştır. Bu Araştırmaya, gönüllü olarak katılmayı kabul eden ve Madde Kullanım Bozukluğu tanısı almış olanlar alınmıştır. 152 katılımcıya, araştırmacılar tarafından hazırlanan anket uygulanmıştır. Bulgular: Gençlerin yaş ortalamasının 21.18±1.25 olduğu saptanmıştır. Araştırma grubunun %64.5’i CYBH’lardan AİDS’i, %27’si CYBH’ların belirtilerini ve %36.8’i CYBH’lardan korunmak için yapılması gerekenleri bilmiştir. Katılımcıların %61.8’inin cinsel ilişkide kondom kullanmadığı saptanmıştır. Gençlerin CYBH bilgi puan ortalaması 3.72±2.17 olarak hesaplanmıştır.Sonuç: Konu ile ilgili eğitim ve müdahale çalışmaları yapılmalıdır. İleri dönemde planlanacak çalışmalarda, madde kullanan bireyler riskli grup olarak değerlendirilmelidi

Nocturnal sweating in obstructive sleep apnoea and its association with sleep parameters

Objective: Nocturnal sweating is a condition frequently encountered in obstructive sleep apnoea (OSA) patients. This study aimed to examine the relationship between nocturnal sweating and sleep parameters in patients with and without OSA. Methods: A total of 355 patients were included in this study. The patients were separated into two groups: group 1, consisting of patients with OSA and group 2, the control group, which contained patients without OSA. The presence of nocturnal sweating and its effect on sleep parameters were obtained by polysomnography and examined. Results: In patients from group 1 that had nocturnal sweating, the rapid eye movement (REM) sleep percentage (12.80%, min-max: 0.40-29.60 vs 14.00%, min-max: 1.10-29.40; p=0.034), and REM episode (3, min-max: 1-6 vs 4, min-max: 1-6; p=0.002) were significantly lower, and the apnoea-hypopnoea index (AHI) (26.70, min-max: 0-107.80 vs 17.40, min-max: 0-108.40; p=0.04) during the REM period was significantly higher compared to the patients from group 2 without nocturnal sweating. There was no difference in nocturnal sweating between group 1 and group 2. Conclusion: This study indicates that the REM sleep period may be suppressed due to high sympathetic activity in relation to nocturnal sweating. Moreover, the high AHI detected during the REM sleep period also indicates the association between increased respiratory events and nocturnal sweating during this period

The Acute Effect of Chlorpromazine on Body Temperature in Intensive Care Unit Patients

Aim: Hypothermia is a rare complication of antipsychotic drugs but serious outcomes including death may result. In this study, we aimed to investigate body temperature alterations in acute phase of chlorpromazine treatment, the relationship of inflammatory indicators and risk factors for hypothermic effect in intensive care unit (ICU) patients. Materials and methods: 63 intensive care patients who needed sedative treatment due to agitation were divided into two groups as Group 1 (n = 30) with temperatures ≤ 38°C, and Group 2 (n = 33) with temperatures > 38°C according to baseline body temperatures. Also, recurrent measurements for 12 hours were made at specific intervals following 25 mg intravenous chlorpromazine. Results: In Group 1, decrease in body temperatures was significant from 4th to 12th hours (p < 0.01), while in Group 2, significant decreases in body temperatures at all measurement hours were observed (p < 0.01). Temperature changes (delta temperature) observed at specific measurement intervals were significantly higher in Group 2 compared to Group 1. That difference was statistically significant at all intervals except for ΔTemperature B-6 (p < 0.05). The odds of hypothermic effects by chlorpromazine were 16%, 46%, 3%, and 18% for Acute Physiology and Chronic Health Evaluation II, procalcitonin, C-reactive protein, and white blood cells, respectively. Conclusion: Chlorpromazine treatment applied for agitation in ICU patients was associated with acute hypothermic effect. Severity of disease and comorbidities might increase risk of hypothermia, and inflammatory biomarkers might be predictors of adverse drug reaction