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Yayın Effects of childhood trauma and clinical features on determining quality of life in patients with bipolar I disorder(Elsevier Science BV, 2014-06-20) Erten, Evrim; Funda Uney, Aslı; Saatçioğlu, İbrahim Ömer; Özdemir, Armağan; Fıstıkçı, Nurhan; Çakmak, DuranBackground: We explored how childhood trauma (CHT) affects the clinical expression of disorder and quality of life in patients with bipolar I (BP I) disorder.Methods: Euthymic patients (n=116) who subsequently received a diagnosis of BP-I disorder were consecutively included and were interviewed using the following sociodemographic and clinical data forms; Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HDRS), Childhood Abuse and Neglect Questionnaire (CANQ) and the 36 item Medical Outcome Study Short Form Health Survey (SF 36) The quality of life of BP-I patients with and without a history of CHT were examined.Results: The percentage of trauma was 61.2%. Patients who had CHT had higher frequencies of depressive episodes (t = -2.38, p=0.019), total episodes (t = -2.25, p=0.026), attempted suicide more often (chi(2)=18.12, p=0.003) and had lower scores on the pain subscale of Lhe SF 36 (z=-2.817, p=0.005). In patients with mixed or rapid-cycling episodes, SF-36 subscale scores except general health and pain were Found to be lower.Limitations: Our sample may fail to reflect the general BD population; the patients were included consecutively and consisted of a majority of female patients.Conclusions: CHT plays an important role in the clinical expression of BP-I disorder and having mixed/rapid-cycling episodes negatively affects both physical and mental components, as measured by the SF-36. While both males and females reported experiencing sexual abuse, female BP-I patients complained about pain more often. It is suggested that treatment of BP-1 patients with a history of CHT should differ from that provided for patients with no CHT history.Yayın Executive functions and thyroid volumes in bipolar patients on lithium treatment(In House Publications, 2014-09-30) Fıstıkçı, Nurhan; Cantürk, Gülsüm; Saatçioğlu, İbrahim Ömer; Erten, Evrim; Keyvan, Ali; Turan, NurtenAim: The purpose of this study was to investigate the relationship between executive functions and thyroid ultrasound parameters in remitted bipolar patients who were on lithium treatment. Methods: In the current study, 25 remitted patients with diagnoses of Bipolar I Disorder having blood lithium, and thyroid hormone levels within the normal range were consecutively enrolled. Healthy control group consisted of 25 euthyroid people matched as an age, sex and education level with the patients. Semi-structured sociodemographic and clinical form, the Structured Clinical Interview for DSM-IV Axis I Disorders, the Montreal Cognitive Assessment (MoCA), the Hamilton Depression Scale, Young Mania Rating Scale, thyroid ultrasonography and the Wisconsin Card Sorting Test (WCST) were applied to both groups. Within the patient group, correlation analysis was performed between WCST performance and thyroid volume. Results: In the present study, no significant difference was found between the bipolar and the healthy control groups regarding the executive functions as measured via WCST. In the bipolar patients, there were no statistically significant correlations among WCST scores and thyroid volumes. Conclusion: Thyroid volumes are not appeared to be associated with executive functions in euthymic bipolar patients.Yayın Attentional bias and training in social anxiety disorder(Turkish Neuropsychiatric Society, 2015-03) Fıstıkçı, Nurhan; Saatçioğlu, İbrahim Ömer; Keyvan, Ali; Topçuoǧlu, VolkanCognitive behavioral therapy (CBT) is one of the most effective treatment modalities for social anxiety disorder (SAD), showing a high level of clinical evidence supporting its effectiveness. On the other hand, lack of the desired benefit from this treatment in some patients causes continuation of the search for new techniques. Recent research studies have focused on attentional bias and attention training in SAD. Attention processes in SAD have been a major target of interest and investigation since the introduction of the first cognitive models explaining SAD. In the first model, it was highlighted that attention was self-focused. The relationship between threatening stimuli and attention was considered in the subsequent models. Attentional bias towards threat may take place in several ways, such as facilitated processing of threat, difficulty in disengaging attention from the threat and avoidance of attention from the threat. After these descriptions regarding the phenomenology of the disorder, treatments to modify attention, processes were developed. In spite of conflicting results, investigations on attentional training are promising. Attention processes, attentional bias and attentional training in SAD are discussed in this review.Yayın Relationship between metabolic syndrome and clinical features, and its personal-social performance in patients with schizophrenia(Springer, 2016-06) Saatçioğlu, İbrahim Ömer; Kalkan, Murat; Fıstıkçı, Nurhan; Erek, Şakire; Kılıç, Kasım CandanThe aim of this study was to evaluate the metabolic syndrome (MS) criteria and also to investigate the effects of MS on medical treatment, clinical course and personal and social performance in patients with schizophrenia. One hundred-sixteen patients with schizophrenia were included in the study. Measurements of MS were calculated in all patients. Brief Psychiatric Rating Scale, Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, Calgary Depression Scale for Schizophrenia, Personal and Social Performance Scale (PSP) were applied. The frequency of MS according to IDF criteria was 42.2 % among the patients. There was no significant difference between patients with and without MS in terms of age. The ratios of MS were 62.5 % for the group taking typical and atypical antipsychotics together and 35.7 % for the group taking two or more atypical antipsychotics together. The duration of disorder in patients with MS was higher than those without MS. Furthermore there was no significant difference between the schizophrenic patients with and without MS, in terms of PSP scores. Our findings showed that the duration of illness, high scores of BMI, use of clozapine or concurrent use of typical and atypical antipsychotics, depressive and negative symptoms of schizophrenia were significant risk factors for the development of MS.Yayın Olanzapin kullanımına bağlı çekilme diskinezisi ve süpersensitivite psikozu(Turkish Neuropsychiatric Society, 2016-06) Karaş, Hakan; Güdük, Mehmet; Saatçioğlu, İbrahim ÖmerTardive dyskinesia (TD) usually appears after years of antipsychotic drug use and appears to be related to the total lifetime medication dose. In withdrawal-emergent dyskinesia (WE-D), which is considered to be a subtype of TD, dyskinetic symptoms often appear shortly after a rapid reduction in antipsychotic drug dose or sudden discontinuation of the drug. Supersensitivity psychosis, which is frequently observed along with TD and is considered to have a similar etiology as TD, is a psychotic relapse phenomenon that occurs after the withdrawal of an antipsychotic drug or a rapid reduction in the drug dosage. In general, atypical antipsychotics tend to be associated with less propensity to cause TD when compared with typical antipsychotics. Furthermore, olanzapine and clozapine may have a therapeutic potential in improving or totally curing TD. In this study, a case of WE-D because of discontinuing olanzapine use and supersensitivity psychosis is discussed.Yayın A clinical case of treatment-resistant schizophrenia: 60 hospitalizations and 342 ECT sessions in 36 years; lack of social support or undertreatment?(İstanbul Üniversitesi, 2015-06) Cesur, Ender; Fıstıkçı, Nurhan; Dönmezler, Fadime Gizem; Saatçioğlu, İbrahim ÖmerIt is reported that between 20% and 25% of patients have schizophrenia that is resistant to treatment. The treatment resistance in schizophrenia is defined by many authorities. One of the generally accepted definitions is inadequate response despite treatment with different atypical antipsychotics, two or three times at least four-six weeks; the other acceptable one is although the use of two different typical or atypical antipsychotics in monotherapy during four-six weeks, inadequate treatment response is obtained. Duratian of hospitalization in treatment resistant cases is longer. In addition, when considering all the expenses and loss of functions, the cost of resistant cases to society is higher. 60 years old, women patient. She was hospitalized from emergency department where she came with his son, because of denial of treatment and homicidal intent. It is learned that age of onset was 24, disease began in a postpartum period, she was diagnosed with schizophrenia and she had 60 hospitalizations. Although clozapine, haloperidol, amisulpiride, risperidone, olanzapine, aripiprazole, quetiapine, chlorpromazine, sulpiride, zuclopenthixol, fluphenazine, lithium and valproate were used adequate doses and time; a total of 342 ECT sessions were administered; response or partial response was achieved, she had not achieved long-term functioning and well-being. In the most recent admission, she had significant improvement with clozapine 275 mg/day and valproat 1000 mg/day. Despite all treatment efforts, schizophrenic patient with excessive admissions and frequent recurrences is discussed.Yayın Yatarak tedavi görmüş geriyatrik unipolar depresyon ve bipolar bozukluk hastaların klinik ve sosyodemografik özelliklerinin karşılaştırılması(Istanbul Universitesi, 2015-12) Cesur, Ender; Fıstıkçı, Nurhan; Dönmezler, Fadime Gizem; Çarpar, Elif; Erten, Evrim; Keyvan, Ali; Saatçioğlu, İbrahim ÖmerAmaç: Bipolar bozukluk, toplumda %1 oranında görülen kronik bir hastalık olmakla beraber, yaşlılardaki yaygınlık oranı % 0.1 kadar düşüktür. Major depresyonun ise 70-85 yaşından sonra prevalans ve insidansı iki kat artmaktadır. Çalışmanın amacı, yatarak tedavi gören bipolar bozukluk(BB) ve unipolar depresyon(UD) tanılarıyla izlenen geriyatrik hastaların sosyodemografik ve klinik özelliklerinin araştırılmasıdır.Yöntem: Çalışmada Bakırköy Ruh ve Sinir Hastalıkları Hastanesi’nde yatmış olan, 65 yaş ve üzeri BB ve UD hastalarının sosyodemografik ve klinik özellikleri tıbbi kayıtları üzerinden karşılaştırılmıştır. Madde/ilaç, başka bir sağlık durumuna bağlı duygudurum bozukluğu tanısı olanlar ya da demans, deliryum tanısı olan hastalar çalışmaya dahil edilmemiştir. Bulgular: Tüm hastaların yaş ortalaması 69,3’tür. Çalışmaya dahil edilen 93 hastanın 51 tanesinde (%54,8) BB, 42 tanesinde(%45,2) UD tanısı bulunmaktadır. Hastalığın başlangıç yaşı BB için 41,33 iken UD için 59,21 bulunmuştur(p=0,000). UD hasta grubunun yatışındaki intihar fikri oranı %78,6 olup BB hasta grubununki %17,6’dır(p=0,000). UD grubundan 20(%47.6) kişi daha önce en az bir kere intihar girişiminde bulunmuşken bu sayı bipolar hasta grubunda 12(%23.5) olarak saptanmıştır(p=0,03). BB hastalarının ilaç uyumsuzluğu %51,0 iken UD hastalarında (%26,2) anlamlı derecede düşüktür (p=0,000). BB grubunun tedavisinde antipsikotikler (%100), depresyon hastalarına (%76,2) oranla daha sık kullanılmıştır(p=0,000). Sonuçlar: Yatarak tedavi görmüş unipolar ve bipolar geriyatrik hastalarda önemli klinik farklar saptanmıştır.
