{"title":"Duloxetine Induced Hyponatremia.","authors":"Ebru Şahan, Fatma Büşra Parlakkaya Yıldız","doi":"10.5080/u23394","DOIUrl":"https://doi.org/10.5080/u23394","url":null,"abstract":"Hyponatremia can be asymptomatic or have a wide range of clinical presentations such as headaches, muscle cramps, nausea, seizures, coma, cerebral edema and may even result in death. Despite it has been suggested that duloxetine has a relatively less risk of hyponatraemia, the number of case reports are increasing. A 45- year old female patient with complaints of fear, anxiety, sleeplessness and headache was started on duloxetine (30 mg/day). In the first week of the treatment, she was admitted to the emergency service with dizziness, dry mouth, polyuria and polydipsia. She had to be transferred to the intensive care unit because of agitation, loss of consciousness and a generalized tonic-clonic seizure. Blood levels of Sodium (Na+), Potassium (K+) and Chlorine (Cl-) were, respectfully, 121 mmol/L, 2.7 mmol/L and 87 mmol/L. Brain imaging displayed cerebral edema. Electrolyte levels were regulated with saline infusions. Amitriptyline was initiated for the ongoing headache and anxiety. In outpatient visits, hyponatremia did not recur in the following 3 months. Low dose duloxetine was associated with severe hyponatremia signs and symptoms in an individual who was not previously considered as high risk for hyponatraemia. The patient's history did not reveal any complaints related to hyponatremia when she was treated with sertraline two years ago. Based on these, we discussed the risk factors for hyponatremia and risky antidepressant classes.","PeriodicalId":94262,"journal":{"name":"Turk psikiyatri dergisi = Turkish journal of psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75183716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Needs of Patients with Schizophrenia and Their Predictors].","authors":"Abdullah Burak Uygur, Ayşen Esen Danacı","doi":"10.5080/u23283","DOIUrl":"https://doi.org/10.5080/u23283","url":null,"abstract":"OBJECTIVE The aim of this study was to explore the needs of patients with schizophrenia and to determine the sociodemographic and clinical variables associated with these needs. METHOD The study was carried out with 94 patients diagnosed with schizophrenia and their primary caregivers. The diagnoses were established based on DSM-IV-TR (American Psychiatric Association 1994) criteria. The patients' needs were evaluated with the Camberwell Assessment of Needs Scale (CAN), which reflects both the patient and the caregiver views on needs and problems. In addition, the Positive and Negative Syndrome Scale, Calgary Depression Scale for Schizophrenia, the Personal and Social Performance Scale, the Quality of Life Scale for Schizophrenia and the Perceived Family Burden Scale were used as data collection tools. RESULTS 'Psychotic symptoms' stood out as the most prevalent need to be met. 'Money' and 'intimate relations' were determined as the needs that the patients suffered most from. Being female, being married, living with families, having high school or higher education were found less associated with the needs. The variables explained 45.1% of the variance in predicting needs and 23.4% in predicting unmet needs. The Calgary Depression Scale for Schizophrenia and Perceived Family Burden Scale were significant predictors for patients and the PANSSPositive Symptoms Scale for caregivers. CONCLUSION Any treatment targeting solely the symptoms proves to be insufficient for patients with schizophrenia. Treatment planning should focus on the needs of patients and the needs identified by patients should be at the center of the treatment. A 'needs assessment' will make an important contribution not only to the planning of individual treatments but also to the planning of a community mental health services scheme and increasing its effectiveness.","PeriodicalId":94262,"journal":{"name":"Turk psikiyatri dergisi = Turkish journal of psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87770450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[The Role of Gut Microbiota in Autism Spectrum Disorder].","authors":"Burcu Ersöz Alan, Fulya Gülerman","doi":"10.5080/U23560","DOIUrl":"https://doi.org/10.5080/U23560","url":null,"abstract":"Human microbiota are colonies of microorganisms located in different parts of the human body with diverse functions. Healthy gut microbiota comprises differing ratios of microoganisms wholly contributing to metabolic and other molecular reactions in a healthy, functioning body. After the demonstration of the bidirectional interaction between the central nervous system and gut microbiota through neuroendocrine, neuroimmune, and autonomic nervous mechanisms, investigations have been started on the microbiota-gut-brain axis in psychiatric disorders. Autism spectrum disorder (ASD), which is a neurodevelopmental disorder of early childhood, is one of these disorders. Most of such studies were cross-sectional and mainly investigated the bacterial species. Changes in gut microbiota composition and the leaky gut syndrome are some of the hypotheses proposed to explain the core symptoms and gastrointestinal (GI) symptoms of ASD. Probiotics, prebiotics, fecal microbiota transplantation, diet have been proposed as treatment options. However, the role of microbiota in diagnosis, followup, and treatment is not yet clear. The bidirectional interaction between central nervous system and intestinal microbiota makes it difficult to establish the cause-effect relationship. The current data on microbiota may be useful to plan patient-specific treatment in autistic children with GI symptoms. This article aims to review the results of the studies on microbiota in animal models and children and discuss the emerging clinical relationship of ASD and gut microbiota.","PeriodicalId":94262,"journal":{"name":"Turk psikiyatri dergisi = Turkish journal of psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86327274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Chromosome Analysis in the Assessment for Gender Affirmation Process: A Retrospective Study].","authors":"A. Bağcaz, O. Boduroglu, K. Başar","doi":"10.5080/u23572","DOIUrl":"https://doi.org/10.5080/u23572","url":null,"abstract":"OBJECTIVE Gender dysphoria refers to the experienced discomfort related to the incongruence between gender identity and the sex assigned at birth. Current treatment approach for this clinical condition is gender affirmation procedures. International guidelines about gender affirmation do not recommend routine genetic evaluation. In Turkey, provision of health insurance for medical expenses incurred by these procedures requires genetic consultation which frequently involves chromosome analysis (karyotyping). However, the contribution of routine chromosome analysis to the assessment and management of gender dysphoria is not established. This study aims to assess the results of chromosome analysis and its effect on the management of gender dysphoria. METHOD The completed chromosome analysis results and observational records of 217 individuals among a total of 281 evaluated for gender affirmation in the psychiatry polyclinic were investigated retrospectively. RESULTS The chromosome analysis results of 213 (98.2 %) of the 217 individuals investigated were congruent with the sex assigned at birth. Variations were found in the karyotypes of 4 individuals with female sex assigned at birth, only 1 of whom had been diagnosed with a disorder of sex development. In the other cases, however, chromosome analysis did not affect the diagnosis or the clinical intervention. CONCLUSION Finding that routine chromosome analysis during the assessment for gender affirmation process rarely affected the clinical diagnosis and the treatment was consistent with the reports of previous studies and supported the recommendation that chromosome analysis should be carried out only in cases where history, physical examination and the required imaging investigations suggested a disorder sex development.","PeriodicalId":94262,"journal":{"name":"Turk psikiyatri dergisi = Turkish journal of psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88864953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Manic Shift Due to the Use of Bupropion in Bipolar Depression:Two Case Reports].","authors":"Evnur Kahyacı Kılıç, Yasemin Görgülü, Rugül Köse Çınar, Mehmet Bülent Sönmez","doi":"10.5080/u23391","DOIUrl":"https://doi.org/10.5080/u23391","url":null,"abstract":"Bupropion is a selective norepinephrine and dopamine reuptakeinhibitor. It is used in the treatment of depression and nicotineaddiction. When compared to the other antidepressants, bupropion hasa relatively lower risk of triggering shift to hypomania or mania in bipolardepression treatment. Here we report two cases of bipolar depressionpatients with manic shift when bupropion was used as an adjunct tomood stabilizer treatment. The first was a 43-year old female patient.Manic symptoms occurred after bupropion was added to lithium andquetiapine treatment for bipolar disorder (BD) depressive episode.Her manic symptoms regressed rapidly after discontinuing bupropiontreatment. The second patient was a 26-year old male on lithium andvalproate therapy with a BD diagnosis. After bupropion was added tohis treatment for depressive symptoms, psychotic mania ensued and hehad to be admitted to the hospital. Significant improvement was notedshortly after bupropion was discontinued and antipsychotic treatmentwas initiated.","PeriodicalId":94262,"journal":{"name":"Turk psikiyatri dergisi = Turkish journal of psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85348464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Gündüz, Esma Akpınar Aslan, F. Eren, Hatice Sodan Turan, M. Öztürk, Ü. Tural
{"title":"Analysis of 24-Hour Heart Rate Variability among Panic Disorder Patients without Previous Drug Treatment and Comorbid Disorders.","authors":"N. Gündüz, Esma Akpınar Aslan, F. Eren, Hatice Sodan Turan, M. Öztürk, Ü. Tural","doi":"10.5080/U23715","DOIUrl":"https://doi.org/10.5080/U23715","url":null,"abstract":"OBJECTIVE One of the METHODS used to assess autonomic nervous system dysfunction in the etiology of panic disorder (PD) is heart rate variability (HRV). HRV is controlled by the sympathetic and parasympathetic (vagal) branches of the autonomic nervous system and reflects the capacity of autonomic stimulation by the parasympathetic system. The aim of this study was to evaluate heart rate variability (HRV) time domain parameters based on twenty four hour holter ECG analysis among drug-naive patients with panic disorder (PD) without any other medical and psychiatric comorbidity. METHOD The study group consisted of 41 patients with PD and 46 healthy controls. Participants were evaluated with SCID-1 for psychiatric diagnoses. Then Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), Panic Disorder Severity Scale (PDSS) and Clinical Global Impression Scale (CGI-S) were applied to participants. Twenty four hour Holter ECG outcomes were analyzed on a computer program and time domain parameters were evaluated. RESULTS Among the parameters analyzed from HRV, SDANN was significantly higher (p <0.001); duration of RMSSD, NN50 and pNN50 were lower in PD group than the control group (p = 0.003, p = 0.005, p = 0.047, respectively). In the correlation analysis, there was a moderate negative correlation between CGI-S and NN50 and pNN50. In logistic regression analysis, the increase in SDNN was found to increase the probability of PD by 1.11 (95% CI, 1.010-1.209); the increase in SDANN was found to decrease the probability of PD by 0.892 (95% CI, 0.818-0.973), and the increase in pNN50 was found to decrease the probability of PD by 0.523 (95% CI, 0.342-0.801). CONCLUSION The data obtained in our study confirm that there is a decrease in some HRV parameters like RMSSD, NN50 and pNN50 reflecting parasympathetic activity among patients with PD.","PeriodicalId":94262,"journal":{"name":"Turk psikiyatri dergisi = Turkish journal of psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77313466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Ince, A. Cansız, S. Ulusoy, K. F. Yavuz, E. Kurt, K. Altınbaş
{"title":"Reliability and Validity Study of the Turkish Version of Bipolar Spectrum Diagnostic Scale.","authors":"B. Ince, A. Cansız, S. Ulusoy, K. F. Yavuz, E. Kurt, K. Altınbaş","doi":"10.5080/U23605","DOIUrl":"https://doi.org/10.5080/U23605","url":null,"abstract":"OBJECTIVE The purpose of this study is to evaluate the reliability and validity of the Turkish Version of the Bipolar Spectrum Diagnostic Scale (BSDS). METHOD The study was carried out with 130 patients diagnosed with bipolar I disorder, 15 patients diagnosed with bipolar II disorder, and 38 patients diagnosed with major depressive disorder attending the outpatient psychiatry departments of the Bakırköy Prof. Dr. Mazhar Osman Training and Research Hospital for Mental Health and Neurological Diseases. The Mood Disorder Questionnaire (MDQ) was used for convergent validity. The internal consistency coefficient, itemtotal score correlation coefficients, test-retest correlation coefficient, confirmatory factor analysis, correlation with concurrent scale, and ROC curve were statistically calculated. RESULTS Confirmatory factor analysis indicated that the 20-item version did not show adequate goodness-of-fit. The item 4 with a relatively low regression weight was removed from the model. For the 19-item revised and corrected model, the observed goodness-of-fit indexes were RMSEA = 0.040, CFI = 0.900, GFI = 0.890, IFI = 0.900 and χ2/df = 1.230. The internal consistency Cronbach's alpha coefficient was 0.831. The correlation coefficient between the Turkish version of the BSDS and the MDQ was 0.54. The cutoff point of the scale calculated by the ROC analysis was 12 with a sensitivity of 78.6% and a specificity of 86.8%. CONCLUSION The Turkish Version of the BSDS, has been shown to be reliable and valid tool for screening bipolar disorder after removal of the item 4 of the original version of the scale.","PeriodicalId":94262,"journal":{"name":"Turk psikiyatri dergisi = Turkish journal of psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86571054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Augmentation of Antipsychotic Treatment with Memantine in Patients with Schizophrenia: A Systematic Review and Meta-Analysis.","authors":"Sefa Vayısoğlu, S. Karahan, A. A. Anıl Yağcıoğlu","doi":"10.5080/U23597","DOIUrl":"https://doi.org/10.5080/U23597","url":null,"abstract":"OBJECTIVE Many patients with schizophrenia respond partially to treatment with antipsychotic medications. A wide range of pharmaceutical agents are utilized as augmentation therapy in order to increase the efficacy of antipsychotic medication treatment. Memantine which is a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist is one such agent among these. In this study, by conducting a systematic review and meta-analysis we aimed to assess the efficacy of memantine augmentation on psychopathology in patients with schizophrenia receiving antipsychotic medication. METHOD We analyzed double-blind, randomized, placebo-controlled trials of memantine add-on treatment in schizophrenia patients receiving antipsychotic medications. The primary outcome measure was amelioration of negative symptoms and the secondary outcome measures were amelioration of positive, total and general psychopathology symptoms. Publication bias was evaluated by Funnel plot and Egger test. RESULTS Eleven studies (n=570) were included. Although memantine add-on treatment was superior to placebo for ameliorating negative symptoms (SMD=0.596, 95% CI=0.075-1.118, p=0.025), there were no statistically significant differences in the amelioration of general psychopathology (SMD=0.034, 95% CI=0.419-0.488, p=0.883), positive (SMD=-0.041, 95% CI=0.217-0.135, p=0.650) and overall (SMD=0.315, 95% CI=0.256-0.887, p=0.280) symptoms. No publication bias was observed between studies according to Funnel plots and Egger test results. CONCLUSION Memantine augmentation treatment seems to be beneficial for particularly treating negative symptoms in schizophrenia patients. Further studies with larger sample size and longer follow-up durations are needed.","PeriodicalId":94262,"journal":{"name":"Turk psikiyatri dergisi = Turkish journal of psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85417274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Persistent Genital Arousal Disorder Treated with Duloxetine: A Case Report].","authors":"N. Gündüz, A. Polat, Hatice Turan","doi":"10.5080/U23441","DOIUrl":"https://doi.org/10.5080/U23441","url":null,"abstract":"Persistent Genital Arousal Disorder is characterized with unwanted, uncontrollable and persistent genital arousal symptoms that occur spontaneously in the absence of simultaneous sexual fantasy, sexual desire or sexual stimulation. The condition may last for hours or days. Patients often find it difficult to share this condition with their health care providers because they are afraid of being diagnosed with hypersexuality and they often get different psychiatric diagnoses such as Obsessive Compulsive Disorder and Major Depressive Disorder. Therefore, little is known about the real prevalence, pathophysiology or etiology of Persistent Genital Arousal Disorder. In addition, since there is no study conducted in this field, our information in this area is limited to case reports. Although there is no consensus about the treatment of Persistent Genital Arousal Disorder in the psychiatric literature, there are some case reports about the use of pregabaline, clomipramine, duloxetine, clonazepam, varenicline, olanzapine, risperidone in addition to the case reports on treatment with hypnotherapy, pelvic floor physiotherapy and electroconvulsive therapy (ECT). In this case report, we aimed to present the detailed description of a successful treatment procedure with duloxetine in a forty two years old female patient diagnosed with Persistent Genital Arousal Disorder. She had been using various antidepressants, antipsychotics, anxiolytics and mood stabilizers for sixteen years with different psychiatric misdiagnoses like Bipolar Disorder, Obsessive Compulsive Disorder, Anxiety Disorder and Major Depressive Disorder and yet, had not shared her symptoms of genital arousal with any psychiatrist previously.","PeriodicalId":94262,"journal":{"name":"Turk psikiyatri dergisi = Turkish journal of psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89845671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Adaptation of the Interpersonal Emotion Regulation Questionnaire to the Turkish Language and Investigation of its Psychometric Properties].","authors":"Ceren Gökdağ, Oya Sorias, Sidar Kıran, Sibel Ger","doi":"10.5080/U23067","DOIUrl":"https://doi.org/10.5080/U23067","url":null,"abstract":"OBJECTIVE This study aimed to adapt the Interpersonal Emotion Regulation Questionnaire (IERQ) to Turkish, and to investigate its psychometric properties. METHOD: A total of 467 volunteers with a mean age of 26.63 years participated to the study. Exploratory and confirmatory factor analyses were conducted after preparing the Turkish version of the IERQ. The relationships between IERQ and other emotion regulation scales were investigated for criterion-related validity. In order to assess reliability, internal consistency coefficients were calculated and subsequently, testretest analyses were repeated on 50 students. RESULTS: As in the original form the Turkish version of IERQ has a 4- factor structure, 'social modelling', 'soothing', 'enhancing positive affect' and 'perspective taking'. As expected, these factors were related to various emotion regulation strategies. Particularly the social modelling and soothing factors differed according to the level of difficulties in emotion regulation. These factors were found to be related to depression, anxiety and stress symptoms. Furthermore, the Turkish version of the IERQ satisfied the conditions of reliability. The internal consistency coefficients of factors were between .81 and .89. Test-retest correlation coefficients were found to be strong. CONCLUSION: This study showed that the Turkish version of IERQ is a reliable and valid scale for the Turkish population. The psychometric properties of the Turkish version were similar to those of the original form.","PeriodicalId":94262,"journal":{"name":"Turk psikiyatri dergisi = Turkish journal of psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73910474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}