Social problem-solving, perceived stress, depression and life-satisfaction in patients suffering from tension type and migraine headaches.

This study aimed at investigating social problem solving, perceived stress, depression, and life-satisfaction in patients with tension type and migraine headaches. Forty-nine migraine and 42 tension type headache patients (n = 91) consenting to participate were compared to a total of 49 matched healthy control group. Participants filled in a questionnaire consisting self-report measures of problem solving, perceived stress, depression and life satisfaction. They were also asked about headache duration, frequency, pain severity, psychiatric treatment and sense of control in one's life. T-tests, chi-square, analysis of variance, logistic regression analysis and Pearson product moment correlation coefficient procedures were used to analyze the data. Tension type headache patients reported having had more frequent headaches than the migraine patients but migraine patients reported having had more intense pain than the tension type headache patients. Instances of psychiatric treatment were more common among tension type headache patients than the migraine and the control group. Compared to the healthy controls, headache patients displayed a deficiency in problem solving, higher levels of perceived stress and depression. Levels of problem solving skills in headache patients were related inversely to depression, perceived stress and the number of negative life events but problem solving skills of headache patients was related positively to life-satisfaction. The findings from this study suggested that cognitive behavioral problem solving therapy or training might be a viable option for reducing levels of stress and depression, and to increase life-satisfaction in patients suffering from primary headache.

Psychiatric inpatients' view of the therapeutic environment: A Turkish interview study.

PURPOSE: The aim of the study was to determine the feelings, thoughts, and experiences of inpatients in a psychiatric clinic about the therapeutic environment of the clinic. DESIGN AND METHODS: The data were collected in interviews using the phenomenological method and interpreted using Strauss and Corbin's approach to qualitative data analysis. FINDINGS: As a result of the data analysis, four themes, "Activities," "Physical Environment," "Personnel," and "Rules" were determined, and each with a number of related subthemes. PRACTICE IMPLICATIONS: The therapeutic environment is a dynamic space that can be modified according to the needs of the patients. Psychiatric nurses will benefit from responding to the feedback from patients by providing, for example, more activities or additional psychotherapeutic interventions.

Sociodemographic and clinical characteristics of synthetic cannabinoid users in a large psychiatric emergency department in Turkey.

Synthetic cannabinoid (SC) use is a global concern and is creating new challenges for treatment services. Although some studies have been reported, there is a need for further research regarding the sociodemographic and clinical characteristics of SC users so that general and psychiatric emergency departments can provide more effective treatments. We aimed to investigate the sociodemographic and clinical characteristics in a cohort of patients using SC who presented to the psychiatric emergency department of the University of Health Sciences, Istanbul Erenköy Training and Research Hospital for Psychiatry and Neurology (ERSHEAH) in Istanbul, Turkey. This cross-sectional and retrospective medical record review examined 340 SC users who presented to the emergency department of ERSHEAH in a 3-month period. The mean age of the SC users was 26.8 ± 7.5 years and 92.6% were men. Psychotic symptoms were present in 247 SC users (78.8%). Severe intoxication was diagnosed in 26 SC users (7.6%), although SC was detectable in the samples of only 6 patients (13.6%). Impaired consciousness (42.3%) was the most common reason for referral to the general hospital and increased liver enzyme levels (15.9%) were the most common indication in the laboratory findings. We observed that the SC users in our sample presenting as psychiatric emergencies were mostly young men experiencing psychotic symptoms. Determining the sociodemographic and clinical properties of SC users may provide an important contribution to fast recognition and more effective management of acute symptoms of SC users in emergency departments.

Suicidal behavior among Turkish patients with Parkinson's disease.

OBJECTIVE: To investigate the predictors of suicidal ideation and attempts among Turkish Parkinson's disease (PD) patients. MATERIALS AND METHODS: The study comprised 120 patients with PD. Clinical findings were obtained by using the Unified Parkinson's Disease Rating Scale. Disease severity was measured by the Hoehn and Yahr staging scale, and the Schwab and England Activities of Daily Living scale was used for patient disability. Psychiatric evaluation was performed by the same psychiatrist using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) Axis I Disorders. Severity of depression was measured with the Hamilton Depression Rating Scale. Suicidal ideation and attempts were considered positive if experienced during the patient's lifetime. The Suicide Probability Scale was used to assess the risk of suicide. Data were analyzed by logistic regression models to identify variables associated with suicidal ideation and attempts. RESULTS: Based on logistic regression analysis, education level, age of disease onset, disease duration, depression, and history of impulse-control disorder (ICD) behaviors were significant predictors of suicidal ideation. The risk rate in the presence of depression and history of ICD behaviors was increased by 5.92 and 4.97, respectively. Additionally, lifetime prevalence of suicidal ideation was found in 11.6% (14 of 120) of PD patients, although no patient had ever attempted suicide. CONCLUSION: Turkish patients with PD who exhibit a high risk for suicidal ideation also experience disease starting at an earlier age, longer disease duration, presence of depression, and ICD behaviors, and should be monitored carefully.

Social phobia in Parkinson's disease: Prevalence and risk factors.

OBJECTIVE: We aimed to investigate the frequency of social phobia in patients with Parkinson's disease (PD). In addition, we explored the relationship between social phobia and the clinical characteristics of PD, and the frequency of comorbid psychiatric disorders in PD patients. METHODS: This study included 80 consecutive patients with PD admitted to the Parkinson's disease and Movement Disorders Clinic at the Erenkoy Research and Training Hospital for Neurologic and Psychiatric Disorders, Istanbul, Turkey and used demographic and clinical data. The PD patients were evaluated during the "on state", using the Hoehn and Yahr scale, the Unified Parkinson's Disease Rating Scale, and the Schwab England Activities of Daily Living Scale. Psychiatric evaluations were conducted using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition structured clinical interview, the Liebowitz Social Anxiety Scale (LSAS), and the Hamilton Depression Rating Scale. RESULTS: Social phobia was diagnosed in 42.5% of PD patients. Social phobia was comorbid with depression in 20 patients (58.8%), generalized anxiety disorder in 18 patients (52.9%), and panic disorder in six patients (17.6%). Social phobia was more frequent in males, early-onset PD, patients with a long duration of disease, the presence of postural instability, and with the use of a high Levodopa equivalent daily dose. A logistic regression analysis revealed the predictive factors of social phobia to be the sex of the patient (more frequent in males) and the presence of postural instability. There was a statistically significantly negative correlation between the LSAS score and the age of disease onset (r=-0.503; P=0.002) and a positive correlation between LSAS score and the duration of disease (r=0.374; P=0.023). CONCLUSION: Social phobia is frequently observed in PD patients. Therefore, the assessment of PD patients should always include psychiatric evaluations, particularly for social phobia. The early detection and treatment of social phobia in PD patients is very important for the quality of life of patients as well as caregivers.

Uric acid levels may be a biological marker for the differentiation of unipolar and bipolar disorder: the role of affective temperament.

BACKGROUND: The aim of this study was to investigate whether uric acid levels are different between patients with remission period of bipolar disorder type I (BD) and patients with remission period of major depressive disorder (MDD). METHODS: For this aim 41 patients diagnosed with BD and 30 patients diagnosed with recurrent MDD according to DSM-IV who were in remission period for at least 8 weeks were evaluated consecutively. The median age and gender distribution of the two groups were similar. Subjects with comorbid psychiatric diagnosis and/or severe medical illnesses were excluded. Affective temperament was evaluated with TEMPS-A (Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire). Plasma uric acid levels were recorded in mg/dl. RESULTS: The uric acid levels of BD patients were found higher than patients with MDD and healthy controls. Additionally uric acid levels of MDD patients were lower than patients with BD and healthy subjects (F=4.183, p=0.039). A moderate correlation between hyperthymic and irritable temperament scores and uric acid levels was detected in both patient groups and in healthy controls. A negative correlation was observed between depressive temperament and uric acid levels only in MDD group. LIMITATIONS: The measurements of temperament were estimated depending on the patient׳s statement. The medications that patients used were not controlled. CONCLUSION: There is a purinergic dysfunction not only in BD but also in MDD patients. High uric acid levels are associated with hyperthymic and irritable temperament scores whereas low uric acid levels are associated with depressive temperament scores.

Temperament, character traits, and alexithymia in patients with panic disorder.

BACKGROUND: The primary aim of the present study was to compare temperament and character traits and levels of alexithymia between patients with panic disorder and healthy controls. METHODS: Sixty patients with panic disorder admitted to the psychiatry clinic at Firat University Hospital were enrolled in the study, along with 62 healthy age-matched and sex-matched controls. The Structured Clinical Interview for DSM-IV axis I (SCID-I), Temperament and Character Inventory (TCI), Toronto Alexithymia Scale (TAS-20), and Panic Agoraphobia Scale (PAS) were administered to all subjects. RESULTS: Within the temperament dimension, the mean subscale score for harm avoidance was significantly higher in patients with panic disorder than in controls. With respect to character traits, mean scores for self-directedness and cooperativeness were significantly lower than in healthy controls. Rates of alexithymia were 35% (n=21) and 11.3% (n=7) in patients with panic disorder and healthy controls, respectively. The difficulty identifying feelings subscale score was significantly higher in patients with panic disorder (P=0.03). A moderate positive correlation was identified between PAS and TAS scores (r=0.447, P<0.01). Moderately significant positive correlations were also noted for PAS and TCI subscale scores and scores for novelty seeking, harm avoidance, and self-transcendence. CONCLUSION: In our study sample, patients with panic disorder and healthy controls differed in TCI parameters and rate of alexithymia. Larger prospective studies are required to assess for causal associations.

Are Uric Acid Levels Different from Healthy Subjects in Bipolar Affective Disorder and Schizophrenia?: Relationship Between Clinical Improvement and Episode Severity in Male Patients.

INTRODUCTION: Purinergic system dysfunction has been shown both in patients with bipolar disorder (BD) and those with schizophrenia. The aim of this study was to evaluate whether uric acid levels in male BD patients with manic episode and schizophrenia patients with psychotic relapse differ from healthy male subjects. Secondly to assess whether uric acid levels in both patient groups correlate with episode severity and if a decrease in uric acid levels correlate with clinical improvement. METHOD: A total of 55 BD patients with manic episode and 59 schizophrenic patients with psychotic relapse were evaluated at baseline and at weeks 1, 2, 3 using the Young Mania Rating Scale (YMRS) and the Positive and Negative Syndrome Scale (PANSS), and their plasma uric acid levels were measured. 60 age-matched healthy males without history of any previous or current psychiatric diagnosis and treatment constituted the control group. In order to determine plasma uric acid levels, blood samples were centrifuged at 3000 × g for 15 minutes, stored at -80°C and measured in milligrams per deciliter. RESULTS: Uric acid levels in both patient groups with manic episode and psychotic relapse were found higher than in healthy controls (f=6.122, p=.027). The difference between repeated measurements of uric acid levels in BD patient group was found to be between baseline and first week measurements (after Bonferroni correction) (p<.001). No correlation was found between YMRS and PANSS scores and uric acid levels at 4 assessment times. CONCLUSION: Uric acid levels in male BD and schizophrenia patients with manic episode and psychotic relapse were similar with each other, and higher than in healthy males. No correlation was found between uric acid levels and episode severity in both groups. However, for patients with BD, a decrease in uric acid levels between baseline and first week seems to be correlated with clinical improvement.

Sociodemographic and Clinical Characteristics of Psychiatric Inpatients Hospitalized Involuntarily and Voluntarily in a Mental Health Hospital.

INTRODUCTION: In this study, we aimed to investigate and compare the sociodemographic and clinical characteristics of psychiatric inpatients hospitalized involuntarily and voluntarily. To our knowledge, there is no study analyzing involuntary psychiatric hospitalization in our country. METHOD: In this retrospective study, we included a total of 504 patients who were involuntarily or voluntarily hospitalized in Bolu Izzet Baysal Mental Health Hospital between 1st of May and 31st October 2010. The data were obtained from the hospital records. RESULT: In the 6-month period, 13.1% of 504 inpatients were hospitalized involuntarily. The number of male patients who were involuntarily hospitalized was higher than the number of female patients. Most of the patients in the involuntary hospitalized group were graduates of primary school, were not married and were not working at the time of hospitalization. Schizophrenia was the most common diagnosis in the involuntarily hospitalized psychiatric patients and these patients needed longer stay in the hospital. The next hospitalization of the involuntarily hospitalized patients was mostly involuntary. CONCLUSION: Most of the involuntarily hospitalized psychiatric inpatients were male, were not working and had the diagnosis of schizophrenia. These general psychiatric risk factors were more important in involuntary hospitalization compared to voluntary hospitalization. We concluded that the high prevalence of involuntary hospitalizations deserved further studies.

The prevalence of social phobia, and its impact on quality of life, academic achievement, and identity formation in university students.

PURPOSE: The present study aimed to determine the prevalence of social phobia, and the sociodemographic variables, substance use patterns, and comorbid psychiatric disorders associated with it. The impact of social phobia on quality of life, academic achievement, and identity formation were also examined. MATERIALS AND METHODS: The study was conducted between 01 March and 01 June 2008, and included 700 undergraduate students at Adnan Menderes University. A sociodemographic data form, the Liebowitz Social Anxiety Scale (LSAS), World Health Organization Quality of Life-Brief Form, Turkish Version (WHOQoL-BREF-TR), and Instrument for Assessing Identity Confusion (IFAIC) were administered to the participants. FINDINGS: In all, 20.9% of the participants had social phobia during the previous year and 21.7% had social phobia for a lifetime. In total, 74.6% of those that had social phobia during the previous year and 76.5% of those that had social phobia for their whole lives also had a specific social phobia. There was a significant difference between the participants with generalized social phobia or a specific social phobia, and those without social phobia, in terms of LSAS and IFAIC scores. Logistic regression analysis showed that the risk of social phobia was 1.7-fold higher among the females than males, 1.5-fold higher among those that lived in cities for the last 15 years than those that lived in towns, 1.9-fold higher among those that lived in cities for the last 15 years than those that lived in villages, and 1.8-fold higher among those that had relatives with a psychiatric illness than those that didn't. Higher socioeconomic status was negatively correlated with the prevalence of social phobia. Cigarette smoking was more prevalent among the students without social phobia and suicidal ideation was more prevalent among the students with social phobia. WHOQOL-BREF-TR scores showed that students without social phobia had significantly higher quality of life quality than those with social phobia. Self-reported academic performance did not significantly differ between the students with social phobia and those without social phobia. CONCLUSION: Social phobia research may be limited, but was highly prevalent among the university students in the present study and had significant negative effects on identity formation and quality of life.