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

Lithium and Thyroid Disorders

Lithium is a mood stabilizator drug which has been used in the treatment of many mental disorders including bipolar disorders, cyclothymia, recurrent depression, and schizoaffective disorder for the last 50 years. Clinical and experimental studies have shown that patients under lithium treatment could develop thyroid disorders in a range from single disorder in TSH response to severe mxyedema. [Archives Medical Review Journal 2003; 12(2.000): 99-114

Bipolar bozuklukta özkıyım davranışlarının değerlendirilmesi

WOS: 000480626400047Purpose: In this study, the relationship between suicidal behavior and sociodemographic, clinical characteristics, impulsivity and childhood traumas of patients were investigated in bipolar disorder. The study sample was composed of patients with bipolar disorder who were followed in the Bipolar Disorder Unit of the Department of Psychiatry of the Medical Faculty of Cukurova University. Material and Methods: The study included 91 patients who were admitted to our outpatient clinic with the diagnosis of Bipolar Disorder. The study data were collected by using the Mood Disorders Form, SCID-I, SCID-II, Young Mania Rating Scale, Hamilton Depression Rating Scale, Suicide Behavior Scale, Childhood Trauma Questionnaire and Barratt Impulsivity Scale. All diagnostic procedures and interviews were performed by the same psychiatrist. Results: Of the 91 patients included in the study, 52 were female and 39 were male. There were history of suicide attempt in 40 of 91 bipolar disorder patients. In the group attempting suicide, the depressive and mixed episodes were more often and the functionality was partially affected during the inter-episode period and the frequency of psychotic features was higher. In addition, we could not find any statistically significant relationship between the two groups for childhood trauma and impulsivity. Conclusion: Bipolar Disorder is a lifelong disease that significantly disrupts functionality. Bipolar disorder is associated with high rates of suicide attempt and completed suicide. In this respect, the investigation of sociodemographic, clinical and other variables among patients with suicidal behavior and the detection of possible risk factors will be effective in preventing possible suicidal behavior

Assessment of suicidal behavior in bipolar disorder

WOS: 000480626400047Purpose: In this study, the relationship between suicidal behavior and sociodemographic, clinical characteristics, impulsivity and childhood traumas of patients were investigated in bipolar disorder. The study sample was composed of patients with bipolar disorder who were followed in the Bipolar Disorder Unit of the Department of Psychiatry of the Medical Faculty of Cukurova University. Material and Methods: The study included 91 patients who were admitted to our outpatient clinic with the diagnosis of Bipolar Disorder. The study data were collected by using the Mood Disorders Form, SCID-I, SCID-II, Young Mania Rating Scale, Hamilton Depression Rating Scale, Suicide Behavior Scale, Childhood Trauma Questionnaire and Barratt Impulsivity Scale. All diagnostic procedures and interviews were performed by the same psychiatrist. Results: Of the 91 patients included in the study, 52 were female and 39 were male. There were history of suicide attempt in 40 of 91 bipolar disorder patients. In the group attempting suicide, the depressive and mixed episodes were more often and the functionality was partially affected during the inter-episode period and the frequency of psychotic features was higher. In addition, we could not find any statistically significant relationship between the two groups for childhood trauma and impulsivity. Conclusion: Bipolar Disorder is a lifelong disease that significantly disrupts functionality. Bipolar disorder is associated with high rates of suicide attempt and completed suicide. In this respect, the investigation of sociodemographic, clinical and other variables among patients with suicidal behavior and the detection of possible risk factors will be effective in preventing possible suicidal behavior

Three Neuroacanthocytosis Cases Representing Different Psychiatric Aspects

WOS: 000285883500019The definition of neuroacanthocytosis syndromes is used to describe a group of diseases, which is characterized by acanthocytosis and neurological abnormalities. Neuroacanthocytosis syndromes are progressive, degenerative and genetically heterogeneous diseases that generally begin at the 3rd or 4(th) decade of life. Age at onset, clinical and laboratory findings, family history, neurological and systemic involvement, and treatment options differ according to the subtypes. The treatment of neuroacanthocytosis syndromes is totally symptomatic and pharmacotherapy and surgery are used. In the literature, half of the neuroacanthocytosis cases are accompanied by vague psychiatric symptoms as beginning signs or full-blown psychiatric symptoms during the course of the disease. In this case series, we present three patients who displayed different psychiatric aspects in a short period of 6 months and were diagnosed with neuroacanthocytosis after thorough investigations in our psychiatry clinic. Common features and differential characteristics of the cases are discussed in the light of relevant literature. (Archives of Neuropsychiatry 2010; 47: 356-9

Assessment of treatment adherence in patients with bipolar disorder

Objective: Non-adherence with medication is very common in patients with Bipolar Disorder (BD) and is the most frequent cause of recurrence. The aim of this study was to assess treatment adherence and related demographic and clinical factors in patients with bipolar disorder. Method: A total of 107 inpatients who had been followed between the years of 2006-2013 were analyzed retrospectively. Patients were recalled and the treatment adherence of 85 bipolar patients in euthymic period were evaluated with Morisky Medication Adherence Scale. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) Axis II (SCID-II) was used to determine the comorbidity of personality disorders. Well, moderately, and poorly adherent patients were compared with respect to clinical and socio-demographic variables and functionality scores. Results: The rate of moderately and poorly adherent patients was 70.6% of the sample. Married patients and patients with social support were more adherent. The rate of previous suicide attempt was higher in well adherers. Comorbidity with personality disorders, alcohol and substance use, and the type of treatment were not associated with adherence. Conclusions: The results of this study have shown that being single and lacking social support were the factors that have the most significant effect on treatment adherence. Good adherers may have a better outcome, so patients with BD especially who do not have efficient social support should be monitored for treatment adherence closely.Objective: Non-adherence with medication is very common in patients with Bipolar Disorder (BD) and is the most frequent cause of recurrence. The aim of this study was to assess treatment adherence and related demographic and clinical factors in patients with bipolar disorder. Method: A total of 107 inpatients who had been followed between the years of 2006-2013 were analyzed retrospectively. Patients were recalled and the treatment adherence of 85 bipolar patients in euthymic period were evaluated with Morisky Medication Adherence Scale. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) Axis II (SCID-II) was used to determine the comorbidity of personality disorders. Well, moderately, and poorly adherent patients were compared with respect to clinical and socio-demographic variables and functionality scores. Results: The rate of moderately and poorly adherent patients was 70.6% of the sample. Married patients and patients with social support were more adherent. The rate of previous suicide attempt was higher in well adherers. Comorbidity with personality disorders, alcohol and substance use, and the type of treatment were not associated with adherence. Conclusions: The results of this study have shown that being single and lacking social support were the factors that have the most significant effect on treatment adherence. Good adherers may have a better outcome, so patients with BD especially who do not have efficient social support should be monitored for treatment adherence closely

Chronic (Interictal) Psychosis and Phenomenon of Forced Normalization: Case Report

WOS: 000276284400047Psychosis in epilepsy can be categorized in relation to seizures or the treatment: ictal psychosis, postictal pyschosis, interictal (chronic) psychosis, "forced normalization" or "alternative psychosis", and de novo psychosis following epilepsy surgery. A schizophrenic condition with permanent psychotic symptoms that occurs in between the seizures or that has no direct relation with the seizures is termed as "interictal pychosis". Such definitions as "schizophrenia-like psychosis of epilepsy" or "chronic (interictal) psychosis" are also proposed for interictal psychosis. The concept of "forced normalization" is described as the decrease or complete normalization of electroencephalographic abnormalities present during the seizures in a patient with epilepsy, concurrent with the onset of psychotic signs. This concept, also called as "alternative psychosis" or "paradoxic normalization", has recently attracted more attention. The psychiatric disorders reported are mostly psychoses. Frequently, this phenomenon of psychosis takes the form of a brief psychotic disorder. Chronic psychosis is a rarely seen condition. In this report, a case with chronic (interictal) psychosis and comorbid phenomenon of forced normalization has been presented