Comparison of Propofol, Etomidate, and Thiopental in Anesthesia for Electroconvulsive Therapy: A Randomized, Double-blind Clinical Trial.

OBJECTIVES: This study aimed to compare the effects of propofol, thiopental, and etomidate, which are routinely used in anesthesia for electroconvulsive therapy (ECT), on the cardiovascular system, seizure variables, recovery, cognitive functions, and response to treatment. METHODS: Male patients hospitalized at the Seventh Psychiatry Clinics of the Bakirköy Teaching Hospital for Psychiatry, Neurology, and Neurosurgery who were treated with ECT were investigated prospectively. The effects on cardiovascular system parameters (heart rate, blood pressure, and blood oxygenation), seizure variables (duration and intensity of seizure), and recovery variables were recorded at every session, on prespecified time points, and the findings of the first session were used in this evaluation. In addition, clinical responses to treatment were evaluated with tests of cognitive functions before and after a course of ECT. Adverse effects were recorded. RESULTS: The sociodemographic characteristics of the 3 treatment groups were similar. There were no significant differences among the groups in terms of effects on cardiovascular system variables, seizure variables, and cognitive functions. The clinical response to ECT was good in all groups, without any significant differences. CONCLUSIONS: Propofol, etomidate, and thiopental are associated with similar safety and efficacy profiles.

[Relatives' knowledge and opinions about schizophrenia]. / Sizofreni Hastalarinin Yakinlarinin Hastalikla Ilgili Bilgi ve Görüsleri.

OBJECTIVE: The aim of the present study was to determine the knowledge and opinions of schizophrenic patients' relatives regarding the disorder, its causes, treatment methods, and treatment outcomes, as well as to determine the variables that affected their knowledge and opinions. METHOD: Data were collected by contacting 332 family members living with schizophrenia outpatients that were treated in 2 different healthcare institutions. A questionnaire form was administered to collect data from the family members regarding demographic features, patients' clinical features, and family members' knowledge of the diagnostics of schizophrenia. The questionnaire also contained 22 statements regarding the etiology, treatment methods, and treatment outcomes of schizophrenia. The data were compared in relation to the demographic features of the relatives and the clinical features of the patients. RESULTS: Most of the family members (62%) referred to the disorder as schizophrenia or psychosis, and 17.5% did not know the name of the disorder. Family members thought schizophrenia was a brain disorder (87.7%), a psychological disorder (95.9%), or a personality disorder (67.5%). All participants agreed with the statement, "medical treatment must be followed". Magical attributions were believed to be involved in the disorder's onset and its treatment by 27.7% of the participants; this belief was correlated with level of education. Duration of the disorder, number of hospitalizations, existence of another psychotic patient in the family, level of education of the family members, and gender were significant predictors for their opinions. CONCLUSION: Clinical features of the patients and demographic features of the family members have a significant effect on the family members' knowledge and opinions. Outcomes of the present study could be used in the development of psychoeducational programs.

Evaluation of Relationship between Obsessive-compulsive Disorder and Dissociative Experiences.

OBJECTIVE: The aim of the study is to evaluate the relationship between obsessive-compulsive disorder (OCD) symptoms and dissociative experiences and the effect of childhood traumatic experiences on this relationship in OCD patients. METHODS: Fifty consecutive OCD patients and 50 healthy controls are enrolled for this study. Sociodemographic and Clinical Data Form, Dissociative Experiences Scale (DES), Padua Inventory (PI) and Childhood Trauma Questionnaire (CTQ) are applied to participants. RESULTS: Average DES total score in the patient group is 20.58 and in the control group it is 4.87. In the patient group, when we evaluate the relation strengths of DES total and subscale scores with PI total score, we found out that amnesia subscale has r=0.361 (p<0.01), absorption subscale has r=0.611 (p<0.01), depersonalization/derealization subscale has r=0.574 (p<0.01), and DES total score has r=0.55 (p<0.01) relation strengths with PI total score. In patient group both DES total score and CTQ total score have influence on PI total score independently from each other. In addition to this, the level of the influence of DES total scores on PI total scores is, R²=0.399 (p<0.01) and the level of the influence of CTQ total scores on PI total scores is R²=0.343 (p<0.01). CONCLUSION: Dissociative experiences are seen more frequently in OCD patients than healthy controls. Among dissociative experiences, absorption has stronger relation with OCD symptoms. The relation between OCD and dissociation is independent from and stronger than the relation between childhood traumatic experiences and OCD.

Assessment of technetium-99m labeled macroaggregated albumin rhinoscintigraphy for the measurement of nasal mucociliary transport rate: intratest, interobserver, and intraobserver reproducibility.

Objectives. The measurement of mucociliary transport velocity by rhinoscintigraphy with Tc-99m-macroaggregated albumin ((99m)Tc-MAA) is reliable measure of mucociliary clearance. The aim of this study is to assess the intratest, interobserver, and intraobserver reproducibility of nasal mucociliary transport rate (NMTR) measurement. Materials and Methods. Twenty-two subjects were evaluated to determine intratest reproducibility and a group of 35 subjects was examined to determine inter- and intraobserver reproducibility. Rhinoscintigraphy with (99m)Tc-MAA was used to measure NMTR in all study subjects. Paired NMTR measurements were compared using a range of statistical methodologies. Intraclass correlation coefficients (ICC) and repeatability coefficients and Bland-Altman plots were applied to assess the degree of intratest, interobserver, and intraobserver variation. Results. Statistical analysis of test and retest experiments demonstrated the statistical equivalence of intratest NMTR measurements, interobserver NMTR measurements, and intraobserver NMTR measurements. The intratest ICC, interobserver ICC, and intraobserver ICC were 0.96, 0.83, and 0.91, respectively, indicating that intratest and intraobserver reproducibility are excellent and interobserver reproducibility is good. Conclusions. Rhinoscintigraphy using (99m)Tc-MAA results in highly reproducible measurement of NMTR. The use of radionuclide imaging in measuring NMTR results in excellent intratest and intraobserver reproducibility and good interobserver reliability.