Intermittent Explosive Disorder

Intermittent explosive disorder is an impulse control disorder characterized by the occurrence of discrete episodes of failure to resist aggressive impulses that result in violent assault or destruction of property. Though the prevalence intermittent explosive disorder has been reported to be relatively rare in frontier studies on the field, it is now common opinion that intermittent explosive disorder is far more common than previously thought especially in clinical psychiatry settings. Etiological studies displayed the role of both psychosocial factors like childhood traumas and biological factors like dysfunctional neurotransmitter systems and genetics. In differential diagnosis of the disorder, disorders involving agression as a symptom such as alcohol and drug intoxication, antisocial and borderline personality disorders, personality changes due to general medical conditions and behavioral disorder should be considered. A combination of pharmacological and psychotherapeutic approaches are suggested in the treatment of the disorder. This article briefly reviews the historical background, diagnostic criteria, epidemiology, etiology and treatment of intermittent explosive disorder

Rapid efficacy of the eye movement desensitization and reprocessing in treatment of persistent complex bereavement disorder:report of two cases

Grief occurs following the loss of a beloved one and it is a normal experience. However, prolonged (>6 months) grief can serve as a ground for a pathological situation. According to DSM-5, persistent complex bereavement disorder (PCBD) is diagnosed if the grief period exceeds twelve months. If this grief experience accompanies a traumatic event, DSM-5 Appendix recommends including Traumatic Death Specifier. In the process of PCBD, there can be several symptoms such as decreased functionality, sleep disorders, depressed mood, guilt feelings, somatic disorders and denial of the death. Eye movement desensitization and reprocessing (EMDR) is one of the treatment methods for PCBD. In this study, two cases diagnosed with PCDB and recovered apparently with a time-limited EMDR treatment are presented

Omentum adiposity is linked with resistin gene expression

Background: This study demonstrated site-specific adipose tissue resistin gene expression differences in individuals with and without type 2 diabetes mellitus. The relationship between conventional drug therapy and adipose tissue resistin gene expression was also determined. Paired omental and subcutaneous adipose tissues were excised during elective surgery from morbidly obese and obese patients. Methods: Resistin mRNA expressions were determined by qPCR. All tissue sections also were also analyzed for their resistin and CD68 protein expressions by immunohistochemistry. Results: No significant difference for omental and subcutaneous adipose tissue resistin mRNA expression levels were found among morbidly obese and obese study groups. The omental adipocytes resistin mRNA expressions increased with macrophage number both in the omental and subcutaneus fat. Resistin mRNA expressions of the omental and subcutaneous fat were in positive correlation. As the omental adipocytes radius decreased, the macrophage number increased in subcutaneous fat. In the omentum the adipocytes diameter and areas increased, in correlation with macrophage number. The antidiabetic drug use was found to increase adipocyte size both in the omentum and subcutaneous fat. Conclusions: The higher resistin gene expression in the omental fat may induce the increase in size and number of adipocytes, thus leading to elavation in omental fat mass

Longterm treatment in bipolar disorder.

TEZ8016Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2010.Kaynakça (s. 68-78) var.viii, 95 s. : res., tab. ; 29 cm.Aim: The aim of this study was to determine the long treatment response and its relationship between clinical variables at follow-up bipolar disorder patient group in Bipolar Disorder Unit of the Department of Psychiatry, Faculty of Medicine, Çukurova University. Material and Methods: One hundred consecutive patients, from the 2009 Bipolar Disorder Mood Unit, are included in this study. ""Affective Disorders Patient Registry Form"" developed by Bipolar Disorder Mood Unit, SCID-II, Young Mani Rating Scale, Hamilton Depression Rating Scale, Prophylactic Treatment Response Scale were used in this study to collect the data. These forms are completed through interviews with patients and their relatives, and evaluation of inpatient files. Results: In this study, 50 of subjects were female, 50 were male. 156 maintenance periods of 100 bipolar patients were examined in our study. In 60,24 % of longterm treatment periods mood stabilizers and antipsychotics were used together but only one type of mood stabilizer was used in 30,75 % of longterm treatment periods . Frequently lithium was prefered as a mood stabilizer (43,58 %) . By longterm treatment, a significant decrease was determined in total number of epizods, epizod frequency and time-ill periods. When the response to longterm treatment was evaluated by Grof scale we determined 97 % as partial response rate and 43,8 % as full response rate. The necessity of antipsychotics incrases when the time-ill periods are prolonged and the number of epizod/year gets higher. Conclusion: Bipolar disorder goes on all life along and disturbs functionality on a large scale. Because of that the consequence of longterm treatment is very important. If the longterm treatment is continued particularly and carefully, time-ill periods decrease prominently. Also selecting unique drugs to patients and illness is very significant.Amaç: Bu çalışmada, Çukurova Üniversitesi Tıp Fakültesi Ruh Sağlığı ve Hastalıkları Anabilim Dalı Bipolar Bozukluk Biriminde düzenli olarak Bipolar Bozukluk tanısıyla izlenen hastaların koruyucu sağaltıma yanıtları ve sağaltıma yanıtın klinik değişkenlerle ilişkisi araştırılmıştır. Gereç ve Yöntem: Çalışmaya, 2009 yılında Bipolar Bozukluk Biriminde Bipolar Bozukluk tanısıyla izlenen rastgele yöntemle seçilmiş 100 hasta alınmıştır. Çalışma verileri tarafımızca geliştirilen ""Duygudurum Bozuklukları Hasta Kayıt Formu"", SCIDI-II, Young Mani Değerlendirme Ölçeği, Hamilton Depresyon Değerlendirme Ölçeği, Koruyucu Sağaltıma Yanıt Ölçeği, İşlevselliğin Genel Değerlendirme Ölçeği kullanılarak toplanmıştır. Formlar hasta ve hasta yakınları ile görüşülerek ve poliklinik kayıtları incelenerek doldurulmuştur. Bulgular: Çalışmaya alınan hastaların 50'si kadın, 50'si erkek'ti. Çalışmamızda 100 bipolar bozukluk hastasının toplam 156 koruma dönemi incelendi. Bu koruma dönemlerinin % 30,75'inde tek duygudurum dengeleyici ilaç, % 60,24'ünde ise duygudurum dengeleyiciye ek olarak antipsikotik kullanılıyordu. Duygudurum dengeleyici olarak en sık seçilen ilaç lityumdu (% 43,58). Koruyucu sağaltım sonrasında dönem sayısı, sıklığı, hastalıkla geçirilen sürelerde anlamlı bir azalma belirlenmiştir. Koruyucu sağaltıma yanıt Grof ölçeği ile değerlendirildiğinde % 43,8 oranında tam yanıt saptanmıştır. Hastalıkla geçen süre uzadıkça ve yılda geçirilen dönem sayısı arttıkça ek olarak antipsikotik kullanma gereksinimi artmıştır. Sonuç: Bipolar Bozukluk yaşam boyu süren ve işlevselliği büyük oranda bozan bir hastalıktır. Bu nedenle koruyucu sağaltımın önemi yüksektir. Koruyucu sağaltım düzenli ve özenli bir şekilde sürdürüldüğünde hastalıkla geçen süre önemli oranda azalmaktadır. Ayrıca koruyucu sağaltımda hastaya ve hastalığa özgü ilacın belirlenmesi de önem taşımaktadır

A case of late onset compulsive sexual addiction

Kompulsif seks bağımlılığı toplumun yaklaşık %-5-6'sını etkileyen klinik bir fenomendir. Erkeklerde çok daha sık görüldüğü bildirilmiştir. Tahmin edilen erkek kadın oranı 3:1'dir. Geç adölesan dönemde ve erken erişkinlik döneminde yaygındır. Bu bireyler sıklıkla seksle ilgili intruzif düşüncelere sahiptir ve seksüel davranışlarını kontrol etmekte güçlük yaşarlar. Bu fenomen bir davranış bağımlılığı ve obsesif kompulsif spektrum bozukluğu olarak değerlendirilebilir ve sosyal açıdan çok sayıda soruna yol açabilmektedir. Anksiyete bozukluğu, depresyon, alkolmadde kötüye kullanımı ve bağımlılığı ile sıklıkla birlikte görüldüğü bildirilmiştir. Seksüel davranışın normal miktarı- nı ölçmek mümkün değildir. Haftalık orgazm sayısı olarak tanımlanan toplam cinsel eylem ölçütü hiperseksüaliteyi tanımlamak için kullanılmaktadır. Burada başlangıç yaşı ve cinsiyet açısından atipik bulduğumuz bir olgu sunulmuşturCompulsive sexual addiction is a clinical phenomenon which affects approximately 5% to 6% of the population. It has been reported to be more common in men than women, with an estimated ratio of male to female 3:1. It is common in late adolescence and early adulthood. People with compulsive sexual addiction have frequent intrusive thoughts about sex and difficulty controlling their sexual behavior which can result in numerous problems. This phenomenon has been evaluated as a behavioral addiction and an obsessive-compulsive spectrum disorder. It has been reported to involve frequent comorbidity with anxiety disorders, depression, alcohol, and drug abuse or dependence. It is not possible to determine the normal frequency of sexual behavior. Total sexual activity as the number of orgasms per week is used to define hypersexuality measure. Here, we reported an atypical case in terms of age of onset and gender

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

Acute psychotic disorder associated with immunosuppressive agent use after renal transplantation: a case report

Kidney transplantation is the best treatment option for end-stage renal disease in appropriate patients. Immunosuppressant agents given in this duration can cause many psychiatric disorders. In this paper, we present a young kidney transplant patient with psychosis constituted delusions about his transplanted kidney after 4 years later from transplantation. He had refused to take his immunosuppressant pills because of psychotic process. In this paper, we wanted to discuss the psychiatric risks of immunosuppressant agents and importance of the psychiatric treatment in this aspect

A case of late onset compulsive sexual addiction

WOS: 000392965100009Compulsive sexual addiction is a clinical phenomenon which affects approximately 5% to 6% of the population. It has been reported to be more common in men than women, with an estimated ratio of male to female 3: 1. It is common in late adolescence and early adulthood. People with compulsive sexual addiction have frequent intrusive thoughts about sex and difficulty controlling their sexual behavior which can result in numerous problems. This phenomenon has been evaluated as a behavioral addiction and an obsessive-compulsive spectrum disorder. It has been reported to involve frequent comorbidity with anxiety disorders, depression, alcohol, and drug abuse or dependence. It is not possible to determine the normal frequency of sexual behavior. Total sexual activity as the number of orgasms per week is used to define hypersexuality measure. Here, we reported an atypical case in terms of age of onset and gender

Impulsivity and impulse control disorders in pregnancy

OBJECTIVE: We investigate the relationship between impulsivity and impulse control disorders (ICDs) in pregnancy. We claim that women with unplanned pregnancies are more impulsive and have a higher frequency of ICDs. METHODS: We perform a study on the 152 pregnant women who applied to Haydarpaşa Numune Training and Research Hospital Obstetrics outpatient clinic for routine follow-up. The participants are informed about the content of the study and their consents are taken. Socio-demographic characteristics of the participants are recorded. ICDs and impulsivity are assessed by Minnesota Impulse Control Disorders Interview Scale and Barrat Impulsivity Scale (BIS). RESULTS: ICD was present in 11.8% of the pregnant women (n = 18) before gestation and 9.2% (n = 14) during gestation. The motor and total impulsivity scores of those diagnosed with ICD during and before pregnancy were higher than those without ICD. The most common ICD during and before pregnancy was compulsive buying (3.3%). The relationship between pregnancy trimester and BIS score is insignificant. CONCLUSION: The motor and total impulsivity scores of those diagnosed with ICD before and during pregnancy were higher than scores of those not having ICD. It is well-known that ICDs cause not only pschiatric comorbidity but also illegal or high-risk behaviours, interpersonal, social, and economical problems. Thus, early recognition and treatment of ICDs in pregnancies will have a positive effect on both mothers’ and babies’ health