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1.
Alcohol Clin Exp Res ; 39(4): 702-9, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25833030

RESUMO

BACKGROUND: Alcoholism is a leading cause of mortality and morbidity. The most widely accepted hypothesis of its etiology is multidimensional and includes biological, psychological, and sociological factors. The biological factors have been the focus of investigation. In recent years, pathways related to nutrition and the relationship between alcohol addiction and craving have been studied. Our aim was to explore the relationship between the appetite hormones (adiponectin, ghrelin, and resistin) and alcohol craving. METHODS: Blood samples were obtained from 107 male patients over a 7-day period. Levels of adiponectin, resistin, and ghrelin, the Obsessive Compulsive Drinking Scale (OCDS) score, and the Penn Alcohol Craving Scale (PACS) score were assessed on days 0 and 7. Adiponectin, resistin, and ghrelin levels were also tested in 83 healthy males in the control group. RESULTS: The sample group consisted of 190 males (107 patients and 83 healthy controls). Comparison of alcohol craving scales with biological markers in the patient group showed a positive correlation between adiponectin levels and the OCDS compulsive subscale scores, and a positive correlation between ghrelin levels and the OCDS total and compulsive subscale scores and the PACS resistance subscale scores. Resistin levels were negatively correlated with the OCDS total, obsessive subscale, and compulsive subscale scores. CONCLUSIONS: Although we did not observe a significant relationship between craving and any of the 3 biomarkers on day 0, craving was positively correlated with the levels of adiponectin and ghrelin and negatively correlated resistin levels on day 7. Our findings support the hypothesis that appetite hormones are trait markers for alcohol craving. Nevertheless, more conclusive results require future studies that evaluate the relationship between these hormones and withdrawal/detoxification period or long-term soberness.


Assuntos
Adiponectina/sangue , Alcoolismo/sangue , Fissura , Grelina/sangue , Resistina/sangue , Adulto , Biomarcadores/sangue , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Fatores de Tempo
2.
Eur Addict Res ; 21(6): 315-20, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26021304

RESUMO

BACKGROUND: Synthetic cannabinoids are compounds that bind cannabinoid receptors with a high potency and have been used widely in Europe by young people. However, little is known about the pharmacology and morphological effects of this group of substances in the brain. This study is aimed at investigating the morphological differences among synthetic cannabinoids users and healthy controls. METHODS: Voxel-based morphometry was used to investigate the differences in brain tissue composition in 20 patients with synthetic cannabinoids use and 20 healthy controls. All participants were male. RESULTS: Compared to healthy controls, voxel of interest analyses showed that regional grey matter volume in both left and right thalamus and left cerebellum was significantly reduced in synthetic cannabinoids users (p < 0.05). No correlation has been found between the age of first cannabis use, duration of use, frequency of use and grey matter volume. DISCUSSION: These preliminary results suggest an evidence of some structural differences in the brain of synthetic cannabinoids users, and point the need for further investigation of morphological effects of synthetic cannabinoids in the brain.


Assuntos
Canabinoides/efeitos adversos , Cerebelo/efeitos dos fármacos , Abuso de Maconha/complicações , Tálamo/efeitos dos fármacos , Adulto , Estudos de Casos e Controles , Cerebelo/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Neuroimagem , Tálamo/patologia , Adulto Jovem
3.
Nord J Psychiatry ; 69(3): 233-9, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25372623

RESUMO

BACKGROUND: Polymorphisms in the genes encoding alcohol metabolizing enzymes are associated with alcohol dependence. AIM: To evaluate the association between the alcohol dehydrogenase 1C (ADH1C) Ile350Val and aldehyde dehydrogenase 2 (ALDH2) Glu504Lys polymorphisms and alcohol dependence in a Turkish sample. METHODS: 235 individuals (115 alcohol-dependent patients and 120 controls) were genotyped for ADH1C and ALDH2 with PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism). Association between the polymorphisms and family history, daily and maximum amount of alcohol consumed was investigated. The associations between alcohol dependence, severity of consumption and family history and the polymorphisms were analyzed by chi-square or Fisher's exact test where necessary. Relationship between genotypes and dependence related features was evaluated using analysis of variance (ANOVA). RESULTS: The -350Val allele for ADH1C (ADH1C*2) was increased in alcohol-dependent patients (P = 0.05). In individuals with a positive family history, the genotype distribution differed significantly (P = 0.031) and more patients carried the Val allele compared with controls (P = 0.025). Genotyping of 162 participants did not reveal the -504Lys allele in ALDH2. CONCLUSIONS: These findings suggest that ADH1C*2 is associated with alcohol dependence in the Turkish population displaying a dominant inheritance model. ADH1C*2 allele may contribute to the variance in heritability of alcohol dependence. The ALDH2 -504Lys/Lys or Glu/Lys genotypes were not present in alcohol-dependent patients, similar to that seen in European populations and in contrast to the findings in the Asian populations.


Assuntos
Álcool Desidrogenase/genética , Alcoolismo/genética , Aldeído Desidrogenase/genética , Etnicidade/genética , Adulto , Aldeído-Desidrogenase Mitocondrial , Alelos , Povo Asiático/genética , Estudos de Casos e Controles , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Polimorfismo de Nucleotídeo Único , Turquia , População Branca/genética
4.
Int J Psychiatry Clin Pract ; 19(1): 60-4, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25363201

RESUMO

OBJECTIVES: Although the medical and economic implications of therapeutic drug monitoring have been intensely discussed over the past years, little is known about the experiences and attitudes of psychiatrists in their clinical practice. The aim of this study was to investigate psychiatrists' daily practice with therapeutic drug monitoring in Turkey. METHODS: A nation-wide cross-sectional survey among adult and child psychiatry specialist psychiatrists in Turkey was conducted. RESULTS: We found that 98.4% (n = 380) of the study participants used TDM in clinical practice and 1.6% (n = 6) did not. However, TDM use is limited to mood stabilizers (lithium 96.3%, valproate 97.6%) to a great extent. Only a small number of psychiatrists perform TDM for other psychotropic drugs, e.g., clozapine 2.4%, tricyclic antidepressants 1.3%, benzodiazepines 1.1%, and selective serotonin reuptake inhibitors 0,8%. CONCLUSIONS: Most of the psychiatrists in Turkey have a positive attitude toward use of therapeutic drug monitoring although there is also a considerable difficulty to reach services for the therapeutic drug monitoring of psychotropics other than mood stabilizers.


Assuntos
Atitude do Pessoal de Saúde , Monitoramento de Medicamentos/estatística & dados numéricos , Psiquiatria , Adulto , Estudos Transversais , Humanos , Psicotrópicos/uso terapêutico , Turquia , Adulto Jovem
5.
Arch Womens Ment Health ; 17(4): 311-5, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24248413

RESUMO

The aim of the present study was to assess the safety and effectiveness of high-frequency repetitive transcranial magnetic stimulation (rTMS) in pregnant patients with depression. Thirty depressed pregnant patients received rTMS over the left prefrontal cortex for 6 days in a week, from Monday to Saturday for 3 weeks. The rTMS intensity was set at 100% of the motor threshold. A 25-Hz stimulation with a duration of 2 s was delivered 20 times with 30-s intervals. A session comprised 1,000 magnetic pulses. Depression was rated using the 17-item Hamilton depression rating scale (HAMD) before and after treatment. Response was defined as a 50% reduction of the HAMD score. Patients with HAMD scores less than 8 were considered to be in remission. The mean HAMD score for the study group decreased from 26.77 ± 5.58 to 13.03 ± 6.93 (p < 0.001) after 18 sessions of rTMS. After the treatment period, 41.4% of the study group demonstrated significant mood improvements as indexed by a reduction of more than 50% on the HAMD score. In addition, 20.7% attained remission (HAMD score < 8), 34.5% achieved a partial response, and 3.4% had worsening in HAMD scores at the end of treatment. Treatment was well tolerated, and no significant adverse effects were reported. rTMS was well tolerated and found to be statistically and clinically effective in pregnant patients with treatment-resistant depression. This study contributed to the existing evidence of the antidepressant effect of rTMS in the treatment of depression in pregnancy.


Assuntos
Depressão/psicologia , Transtorno Depressivo Resistente a Tratamento/terapia , Córtex Pré-Frontal/fisiologia , Estimulação Magnética Transcraniana/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antidepressivos/uso terapêutico , Depressão/tratamento farmacológico , Transtorno Depressivo Resistente a Tratamento/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Córtex Motor/fisiologia , Gravidez , Complicações na Gravidez , Resultado da Gravidez , Escalas de Graduação Psiquiátrica , Estimulação Magnética Transcraniana/efeitos adversos , Resultado do Tratamento , Adulto Jovem
6.
Toxicol Mech Methods ; 23(9): 684-8, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24024663

RESUMO

Heroin is among the most widely used and dangerous addictive opiate. The World Health Organization (WHO) estimated that more than 15 million people are under the influence of opiate addiction. The aim of this study was to investigate copper zinc-superoxide dismutase (Cu,Zn-SOD), catalase (CAT) and selenium-dependent glutathione peroxidase (Se-GPx) antioxidant enzyme activities, malondialdehyde (MDA) levels and the frequency of micronuclei (MN) in addicts using heroin, the most commonly abused opiate in Turkey. Addicts were defined as individuals diagnosed according to "Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV)" criteria by the "Alcohol and Substance Abuse Treatment and Education Centre-Ankara (AMATEM)". The control group had no addiction. In comparisons between the groups, a significant decrease in Cu,Zn-SOD activity and increases in MDA levels and MN frequency were observed in addicts. It can be concluded that opiates may cause oxidative stress and that antioxidant supplementation, in addition to pharmacological and psychiatric approaches, can reduce the toxicological effects of these opiates.


Assuntos
Catalase/sangue , Glutationa Peroxidase/sangue , Dependência de Heroína , Micronúcleos com Defeito Cromossômico/induzido quimicamente , Estresse Oxidativo/efeitos dos fármacos , Superóxido Dismutase/sangue , Adolescente , Adulto , Eritrócitos/efeitos dos fármacos , Eritrócitos/enzimologia , Heroína/toxicidade , Dependência de Heroína/enzimologia , Dependência de Heroína/genética , Humanos , Masculino , Malondialdeído/sangue , Testes para Micronúcleos , Pessoa de Meia-Idade , Turquia , Adulto Jovem
7.
Psychiatry Clin Psychopharmacol ; 33(2): 70-75, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38765930

RESUMO

Background: It is known that there is a relationship between psychotic disorders and the presence of cerebral midline defects, such as the cavum septum pellucidum and the absence of adhesio interthalamica. This study aims to investigate whether these defects in people with alcohol/substance use disorders are associated with the occurrence and persistence of psychotic symptoms. Methods: The files of the patients who were hospitalized in an addiction inpatient unit were retrospectively scanned. The presence of cavum septum pellucidum and the absence of adhesio interthalamica were determined by evaluation of the magnetic resonance imaging findings. The presence of psychotic symptoms at admission and the persistence of psychotic symptoms after 2 weeks of detoxification treatment were used as dependent variables in different logistic regression models. The presence of cavum septum pellucidum and the absence of adhesio interthalamica were included in 2 separate models as independent variables. Results: The results of the regression analyses showed no significant relationship with respect to cavum septum pellucidum. However, the analyses revealed that the absence of adhesio interthalamica increases the risk of the persistence of psychotic symptoms. Conclusion: Our findings suggest that the absence of adhesio interthalamica can be considered a structural risk factor for the development of psychosis in people receiving treatment for substance use.

8.
Subst Abuse ; 17: 11782218231157340, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36865052

RESUMO

Background: Hepatitis C virus (HCV) infection is very common in people who inject drugs (PWID). Studies about the prevalence and genotype distribution of the HCV among PWID are very crucial for developing strategies to manage HCV infection. This study's objective is to map the distribution of HCV genotypes among PWID from various regions of Turkey. Method: This prospective, multicenter, cross-sectional study involved 197 PWID who tested positive for anti-HCV antibodies from 4 different addiction treatment facilities in Turkey. Interviews were done with people who had anti-HCV antibodies, and blood samples were taken to check the HCV RNA viremia load and genotyping. Results: This study was conducted on 197 individuals with a mean age of 30.3 ± 8.6 years. 9.1% (136/197 patients) had a detectable HCV-RNA viral load. Genotype 3 was the most commonly observed genotype by 44.1%, followed by genotype 1a by 41.9%, genotype 2 by 5.1%, genotype 4 by 4.4%, and genotype 1b by 4.4%. Whereas genotype 3 was dominant with 44.4% at the central Anatolia region of Turkey, the frequencies of genotypes 1a and 3, which were predominantly detected in the south and northwest regions of Turkey, were very close to each other. Conclusion: Although genotype 3 is the predominant genotype in the PWID population in Turkey, the prevalence of HCV genotype varied across the country. To eliminate HCV infection in the PWID, treatment and screening strategies that differ by genotype are essentially required. Especially identification of genotypes will be useful in developing individualized treatments and determining national prevention strategies.

9.
World J Biol Psychiatry ; 24(2): 79-117, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-35900161

RESUMO

AIM: This is the third version of the guideline of the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Posttraumatic Stress Disorders (published in 2002, revised in 2008). METHOD: A consensus panel of 33 international experts representing 22 countries developed recommendations based on efficacy and acceptability of available treatments. In total, 1007 RCTs for the treatment of these disorders in adults, adolescents, and children with medications, psychotherapy and other non-pharmacological interventions were evaluated, applying the same rigorous methods that are standard for the assessment of medications. RESULT: This paper, Part I, contains recommendations for the treatment of panic disorder/agoraphobia (PDA), generalised anxiety disorder (GAD), social anxiety disorder (SAD), specific phobias, mixed anxiety disorders in children and adolescents, separation anxiety and selective mutism. Selective serotonin reuptake inhibitors (SSRI) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are first-line medications. Cognitive behavioural therapy (CBT) is the first-line psychotherapy for anxiety disorders. The expert panel also made recommendations for patients not responding to standard treatments and recommendations against interventions with insufficient evidence. CONCLUSION: It is the goal of this initiative to provide treatment guidance for these disorders that has validity throughout the world.


Assuntos
Psiquiatria Biológica , Transtorno Obsessivo-Compulsivo , Transtornos de Estresse Pós-Traumáticos , Adulto , Adolescente , Criança , Humanos , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico , Transtornos de Ansiedade/tratamento farmacológico , Inibidores Seletivos de Recaptação de Serotonina , Ansiedade
10.
World J Biol Psychiatry ; 24(2): 118-134, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-35900217

RESUMO

AIM: This is the third version of the guideline of the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Posttraumatic Stress Disorders which was published in 2002 and revised in 2008. METHOD: A consensus panel of 34 international experts representing 22 countries developed recommendations based on efficacy and acceptability of the treatments. In this version, not only medications but also psychotherapies and other non-pharmacological interventions were evaluated, applying the same rigorous methods that are standard for the assessment of medication treatments. RESULT: The present paper (Part II) contains recommendations based on published randomised controlled trials (RCTs) for the treatment of OCD (n = 291) and PTSD (n = 234) in children, adolescents, and adults. The accompanying paper (Part I) contains the recommendations for the treatment of anxiety disorders.For OCD, first-line treatments are selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioural therapy (CBT). Internet-CBT was also superior to active controls. Several second-line medications are available, including clomipramine. For treatment-resistant cases, several options are available, including augmentation of SSRI treatment with antipsychotics and other drugs.Other non-pharmacological treatments, including repetitive transcranial magnetic stimulation (rTMS), deep brain stimulation (DBS) and others were also evaluated.For PTSD, SSRIs and the SNRI venlafaxine are first-line treatments. CBT is the psychotherapy modality with the best body of evidence. For treatment-unresponsive patients, augmentation of SSRI treatment with antipsychotics may be an option. CONCLUSION: OCD and PTSD can be effectively treated with CBT and medications.


Assuntos
Psiquiatria Biológica , Transtorno Obsessivo-Compulsivo , Transtornos de Estresse Pós-Traumáticos , Adulto , Adolescente , Criança , Humanos , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico , Inibidores Seletivos de Recaptação de Serotonina , Transtornos de Ansiedade/tratamento farmacológico , Ansiedade , Resultado do Tratamento
11.
Noro Psikiyatr Ars ; 59(2): 91-97, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35685050

RESUMO

Introduction: The relationship between BDNF gene Val/Met polymorphism and clinical symptoms, attention and executive functions in patients with schizophrenia was investigated in this study. Also, BDNF Val66Met gene polymorphism was compared between patients and healthy controls. Thus, genetic factors that may affect both the etiology and cognitive functions in schizophrenia were evaluated. Methods: BDNF Val66Met gene polymorphism was investigated in 102 patients with schizophrenia and 98 healthy controls. Cognitive functions were evaluated by the Wisconsin Card Sorting Test (WCST) and Stroop Test. Results: There was no difference in terms of the genotypic or allelic distribution of BDNF Val66Met polymorphism between patients and healthy controls. A significantly higher percentage of suicide attempts were found in the patients having Met allele (Val/Met and Met/Met). Met allele was associated with failure in focused attention and response inhibition in patients with schizophrenia. Conclusion: The presence of the Met allele could be associated with the risk of suicide attempts in patients with schizophrenia. Impairment in executive function areas such as focused attention and response inhibition appears to be related to the Met allele.

12.
Alpha Psychiatry ; 22(1): 61-66, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36426209

RESUMO

Objective: This study aimed to investigate the effects of anger and family functions on bullying behavior in adolescents and young adults who are followed up with the diagnosis of substance use disorder. Methods: A total of 100 patients, whose ages were between 15 and 25 years and who were diagnosed as having substance use disorder, were included as study participants. All participants were subjected to the Sociodemographic Data Form, Family Assessment Device, Trait Anger-Anger Expression Scale, and Bullying Tendency Scale. Results: It was found that there was a positive relationship between bullying tendency scores and trait anger and anger expression outward scores and a negative relationship with anger control scores. It was observed that there was a positive correlation between subdimension scores of problem solving, roles, and showing necessary attention with respect to family function dimensions and bullying tendency scores. In the multivariate regression model evaluating the predictive power of independent factors associated with bullying tendency, it was observed that anger control from anger subdimensions and problem solving from family function subdimensions had a predictive effect on bullying tendency, and the combination of these 2 factors explained 26% of bullying tendency scores. Conclusion: In this study, it was observed that most of the anger and family function dimensions were related to bullying tendency; in particular, the anger control difficulties and the problem-solving skills in the family were the factors that predicted bullying behavior. We think that addressing these factors that have an impact on bullying behavior in the treatment process will be important to regulate the relations with the outside world in this age group.

13.
Perspect Psychiatr Care ; 57(1): 399-407, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33073870

RESUMO

PURPOSE: To investigate health anxiety-related factors in the early stages of pandemic in Turkey. DESIGN AND METHODS: This study included 1046 participants who responded to the online survey anonymously between 28 March and 04 April 2020. FINDINGS: Demographic data, postpandemic attitudes towards the elderly and precaution-taking behaviors were health anxiety-related factors. The main predictors of the health anxiety were the level of hopelessness, perception of self, time spent on social media, and following COVID-19 pandemic-related news. PRACTICE IMPLICATIONS: The results of this study are important in terms of understanding the health anxiety during the pandemic and providing data support for the proper interventions.


Assuntos
Ansiedade/psicologia , Atitude , COVID-19 , Esperança , Resiliência Psicológica , Autoimagem , Mídias Sociais , Adolescente , Adulto , Idoso , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2 , Fatores de Tempo , Turquia , Adulto Jovem
14.
Alpha Psychiatry ; 22(2): 73-78, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36425930

RESUMO

Objective: Alcohol use disorder (AUD) is a disease with chronic relapses. Risk factors of craving, which is thought to be one of the predictors of relapse, have been studied for a long time. The DRD4 gene is located on chromosome 11p and has a 48-base pair variable number of tandem repeat (VNTR) polymorphisms in the 3rd exon. This study aimed to investigate if a relationship existed between craving and DRD4 VNTR polymorphism and to determine the predictors of craving. Methods: A total of 125 patients with AUD were included in the study. The sociodemographic data form, the Michigan Alcoholism Screening Test (MAST), the Obsessive Compulsive Drinking Scale (OCDS), and the Penn Alcohol Craving Scale (PACS) were applied to the patients. Polymerase chain reaction (PCR) was used to determine the DRD4 VNTR variant of all participants in the peripheral blood sample. Results: In the 4R/4R homozygous group, it was found that the age at first alcohol use was higher and the scores of the OCDS on the seventh day were lower, but this relationship could not be demonstrated in further statistical analyses. In the stepwise linear regression model, the age at first alcohol use, MAST score, duration of AUD, and delirium tremens history were found to be the predictors of craving. Conclusion: DRD4 VNTR polymorphism does not play a role as a predictor of craving. A decrease in age at first alcohol use, an increase in the MAST score, and the presence of delirium tremens were found to be the predictors of craving among the participants of this study.

15.
J Alzheimers Dis ; 83(4): 1563-1601, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34487051

RESUMO

Neurological disorders significantly impact the world's economy due to their often chronic and life-threatening nature afflicting individuals which, in turn, creates a global disease burden. The Group of Twenty (G20) member nations, which represent the largest economies globally, should come together to formulate a plan on how to overcome this burden. The Neuroscience-20 (N20) initiative of the Society for Brain Mapping and Therapeutics (SBMT) is at the vanguard of this global collaboration to comprehensively raise awareness about brain, spine, and mental disorders worldwide. This paper aims to provide a comprehensive review of the various brain initiatives worldwide and highlight the need for cooperation and recommend ways to bring down costs associated with the discovery and treatment of neurological disorders. Our systematic search revealed that the cost of neurological and psychiatric disorders to the world economy by 2030 is roughly $16T. The cost to the economy of the United States is $1.5T annually and growing given the impact of COVID-19. We also discovered there is a shortfall of effective collaboration between nations and a lack of resources in developing countries. Current statistical analyses on the cost of neurological disorders to the world economy strongly suggest that there is a great need for investment in neurotechnology and innovation or fast-tracking therapeutics and diagnostics to curb these costs. During the current COVID-19 pandemic, SBMT, through this paper, intends to showcase the importance of worldwide collaborations to reduce the population's economic and health burden, specifically regarding neurological/brain, spine, and mental disorders.


Assuntos
Carga Global da Doença , Cooperação Internacional , Transtornos Mentais , Doenças do Sistema Nervoso , COVID-19/epidemiologia , Carga Global da Doença/organização & administração , Carga Global da Doença/tendências , Saúde Global/economia , Saúde Global/tendências , Humanos , Transtornos Mentais/economia , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Doenças do Sistema Nervoso/economia , Doenças do Sistema Nervoso/epidemiologia , Doenças do Sistema Nervoso/terapia , Neurociências/métodos , Neurociências/tendências , SARS-CoV-2
16.
BMC Fam Pract ; 11: 30, 2010 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-20426828

RESUMO

BACKGROUND: Anxiety disorders are common and are frequently not diagnosed accurately in primary care. Our aim was to determine the knowledge gaps of general practitioners (GPs) in the diagnosis and treatment of anxiety disorders by using vignettes. METHODS: A cross-sectional survey was completed with 255 primary care physicians (response rate 59.4%) in Manisa, a city in western Turkey. From the postal questionnaire, information on working experience, postgraduate education in psychiatry, the interests of the physicians in psychiatry were obtained. The physicians' diagnosis and treatment preferences for generalized anxiety disorder (GAD), social phobia (SP), and obsessive compulsive disorder (OCD) were determined through clinical vignettes prepared for data collection. RESULTS: Two hundred and twenty-seven (89.0%) out of 255 GPs included the diagnosis of obsessive compulsive disorder in their differential diagnosis; however, the rates for social phobia and generalized anxiety disorder were 69.4% (n = 177) and 22.3% (n = 57), respectively. GPs with a post-graduate education on psychiatry diagnosed vignettes more accurately for OCD (p = 0.04). For all three cases, GPs mostly preferred a combination therapy including psychotherapy and psycho-pharmacotherapy. The referral rate to a psychiatrist was between 23.1 and 30.6%. The percentages of the prescription of selective serotonin reuptake inhibitors (SSRI) in accurate diagnosis were 59.3 for social phobia, 33.3 for GAD, and 55.5 for OCD. CONCLUSIONS: There is a gap of knowledge in GPs, which leads to poor recognition and management of anxiety disorders in primary care. Effective interventions including post-graduate education and updated guidelines on anxiety disorders should be planned and implemented with their assessments by vignettes.


Assuntos
Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/terapia , Médicos de Família , Padrões de Prática Médica/estatística & dados numéricos , Atenção Primária à Saúde/normas , Adulto , Ansiolíticos/uso terapêutico , Competência Clínica , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/terapia , Transtornos Fóbicos/diagnóstico , Transtornos Fóbicos/terapia , Psicoterapia , Encaminhamento e Consulta/estatística & dados numéricos , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Inquéritos e Questionários , Turquia
17.
Subst Abus ; 31(4): 270-2, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21038181

RESUMO

Abuse of drugs including addictive ingredients is common among patients with initial addiction history. This article reports a patient who had experienced a panic attack due to cannabis intoxication and has began to abuse an antiepileptic drug barbexaclone after he had quitted cannabis.


Assuntos
Anticonvulsivantes/efeitos adversos , Abuso de Maconha/complicações , Fenobarbital/análogos & derivados , Transtornos Relacionados ao Uso de Substâncias/complicações , Adulto , Humanos , Masculino , Fenobarbital/efeitos adversos
18.
Turk Psikiyatri Derg ; 31(4): 232-238, 2020.
Artigo em Turco | MEDLINE | ID: mdl-33454934

RESUMO

OBJECTIVE: Neuropeptide Y (NPY) is a protein widely expressed in the central nervous system and involved in diverse physiological processes, such as emotional regulation, nutritional behavior, and stress. In some populations, studies on alcohol dependence (AD) and the NPY gene have found that NPY variations increase alcohol consumption and thus may potentially be associated with AD. In this study, we investigated the relationship between NPY gene promoter polymorphisms and phenotypes related to alcohol use. METHOD: A total of 417 male participants comprising 252 individuals with AD and 165 healthy individuals were included in this study and phenotypic data were collected. Polymerase chain reaction-restriction fragment length polymorphism (PCR/RFLP) and DNA sequencing METHODS were used for genotyping the rs16147 and rs17149106 polymorphisms in the promoter region of the NPY gene. The data of 384 participants were analysed to evaluate the possible relationship between genotypes and the diagnosis of AD, family history of AD, the severity of AD using the Michigan Alcoholism Screening Test (MAST), the age of onset of problematic alcohol use, the average amount of alcohol consumed per day for the last six months and the lifetime maximum alcohol consumption in one day. RESULTS: A significant difference was found between the AD and control groups concerning rs16147 polymorphism genotype distribution (p=0.025). No association with polymorphisms and alcohol-related phenotypes were demonstrated in the AD group. CONCLUSION: To our knowledge, this study shows for the first time in the literature that alcohol dependence is associated with NPY rs16147 polymorphism in the Turkish population.


Assuntos
Alcoolismo/genética , Predisposição Genética para Doença , Neuropeptídeo Y/genética , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Polimorfismo de Nucleotídeo Único , Turquia , População Branca/genética
19.
Psychiatry Clin Neurosci ; 63(5): 693-700, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19788631

RESUMO

AIM: The aim of the present study was to investigate the differences in the antioxidant-oxidant balance (AO-OB) between schizophrenic patients and healthy individuals and to explore the relationship of AO-OB with illness subtypes and symptom profiles. METHODS: After a 15-day drug-free period, schizophrenia patients (n = 50) in a clinical sample, and age- and sex-matched healthy subjects (n = 49) were enrolled. Total antioxidant potentials (TAOP) and total peroxide levels (TPEROX) of all participants were measured and the oxidative stress index (OSI) was calculated. The assessment included structured measurements, including the Positive and Negative Syndrome Scale (PANSS), and the Brief Psychiatric Rating Scale (BPRS). RESULTS: TAOP had a significant positive correlation with age at onset of schizophrenia (P = 0.013), a negative correlation with the PANSS negative subscale scores (P = 0.008), a negative correlation with the PANSS total scores (P < 0.001), and a significant negative correlation with BPRS scores (P = 0.001). OSI had a significant negative correlation with age at onset (P = 0.046) and a significant positive correlation with PANSS negative subscale (P = 0.015). A multiple regression model indicated a significant linear combination of age, gender, duration of illness, subtype of schizophrenia, and PANSS scores, in which only the subtype of schizophrenia made a statistically significant contribution to predicting mean OSI (F[5,35] = 2.44, P = 0.04). CONCLUSION: Several parameters in the pathogenesis of schizophrenia, such as age of onset, level of negative symptoms, and subtype of illness, but not the presence of the illness itself, are associated with the level of oxidative stress.


Assuntos
Antioxidantes/metabolismo , Estresse Oxidativo/fisiologia , Peróxidos/sangue , Esquizofrenia/diagnóstico , Adulto , Idade de Início , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Esquizofrenia/sangue , Índice de Gravidade de Doença
20.
Clin EEG Neurosci ; 50(5): 303-310, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30642219

RESUMO

Logistic regression (LR) and artificial neural networks (ANNs) are widely referred approaches in medical data classification studies. LR, a statistical fitting model, is suggested in medical problems because of its well-established methodology and coefficients contributing to the evaluation of clinical interpretations. ANNs are graphical models structured with node networks interconnected with arcs each of which is expressed in terms of weights discovered throughout the modeling process. Since ANNs have a complex structure with its layers and nodes in the layers, which provides ANNs the ability to model any data with complex relationships. Among the various models having origins in statistics and computer science, LR and ANNs have prevailed in the area of mass medical data classification. In this study, we introduce the 2 aforementioned approaches in order to generate a model dichotomizing 75 opioid-dependent patients and 59 control subjects from each other. Quantitative electroencephalography (QEEG) absolute power value of each electrode were calculated for 4 consecutive frequency bands namely delta, theta, alpha, and beta with the frequencies, 0.5 to 4, 4 to 8, 8 to 12, and 12 to 20 Hz, respectively. Significant independent variables contributing to the classification were underlined in LR while a feature selection (FS) method, genetic algorithm, is being applied to the ANN model to reveal more informative features. The performances of the classifiers were finally compared considering overall classification accuracies, area under receiver operating characteristic curve scores, and Gini coefficient. Although ANN-based classifier outperformed compared with LR, both models performed satisfactorily for absolute power measure in beta frequency band. Our results underline the potential benefit of the introduced methodology is promising and is to be treated as a clinical interface in dichotomizing substance use disorders subjects and for other medical data analysis studies.


Assuntos
Analgésicos Opioides/uso terapêutico , Eletroencefalografia , Modelos Logísticos , Redes Neurais de Computação , Adulto , Algoritmos , Grupos Controle , Eletroencefalografia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Processamento de Sinais Assistido por Computador
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