Psychiatric symptoms, challenging behaviour and utilization of psychiatric services among adults with intellectual disabilities in Turkey.

BACKGROUND: The aim of this study was to investigate the prevalence of and the factors associated with psychiatric symptoms (PS) and challenging behaviour (CB) in adults with intellectual disabilities, and the utilization of psychiatric services in Turkey. METHOD: Psychiatric Assessment Schedule for Adults with Developmental Disorders Checklist-Revised was used for PS and a structured form for other variables in 771 participants. RESULTS: Of the participants, 50.1% had PS and 36.4% presented with CB. Multivariate analysis revealed that a higher level of needs, better verbal ability, residential living, incontinence and CB, and lifetime suicidal ideation/attempt were independently associated with PS. For CB, it emerged as male carer, PS, lifetime suicidal attempt/ideation, lower level of verbal ability and autism spectrum disorder. Barriers were experienced by 64.7% of participants within the previous year. CONCLUSIONS: Psychiatric symptoms and CB seem to be problems for a significant proportion of adults with intellectual disabilities in Turkey, and there are certain barriers to psychiatric services.

Sociodemographic characteristics of Turkish patients who violated a supervised probation program.

We aimed to investigate sociodemographic characteristics of individuals under a supervised probation program used in Turkey and to compare characteristics of noncompliant versus no-need-to-treat individuals in order to determine the effect of sociodemographic characteristics on success of the supervised probation program. In total, 4,006 individuals who submitted to the supervised probation program of our hospital were evaluated retrospectively from patient data and follow-up records. The mean age of patients was 28.4 ± 8.0 years. We compared the sociodemographic characteristics of "no-need-to-treat" patients (n = 2,205) and "noncompliant" patients (n = 391). We found differences between sociodemographic characteristics of no need to treat and noncompliant groups. We conclude that age, education, presence of self-mutilation, starting age of smoking or substance use, and family history are important factors affecting treatment compliance and success. Therefore, more detailed programs for noncompliant patients should be developed to increase treatment performance.

The Effect of Synthetic Cannabinoids on P-Wave Dispersion: An Observational Study.

OBJECTIVE: The aim of this study was to investigate the effect of synthetic cannabinoids (SC) on P-wave dispersion (PD) in patients who consume SC. MATERIALS AND METHODS: The study population included 72 patients who consumed SC and 36 age- and sex-matched healthy controls. The severity of addiction was detected using the addiction profile index (BAPI). The PD was measured by 12-lead ECG obtained upon admission to hospital. Statistical analyses were performed using the SPSS v20.0 statistical software package. RESULTS: The mean age of the patients and controls was 26.9 ± 7.0 and 26.3 ± 6.5 years, respectively. Mean duration of SC consumption was 1.7 ± 0.7 years. Mean BAPI score of patients who consumed SC was 12.8 ± 3.4. Patients who consumed SC had a significantly higher PD value than controls (37.7 ± 11.5 vs. 30.6 ± 6.4 ms, p < 0.001). The BAPI score was significantly correlated with PD value (r = 0.675, p < 0.001). In the linear regression model that included PD value, age and heart rate, PD value was significantly and independently correlated with BAPI score (r2 of the model = 0.339; p < 0.001). CONCLUSIONS: In this study, patients who consumed SC had significantly higher PD values than controls, and the BAPI score correlated with the PD value. Hence SC consumption could lead to an increased risk of cardiovascular disease through prolonged PD. We recommend the use of the simple and inexpensive ECG to assess cardiovascular risk in patients who consume SC.

Effect of Different Psychoactive Substances on Serum Biochemical Parameters.

BACKGROUND: Psychoactive substances affect mainly central nervous system and brain function causing changes in behavior. OBJECTIVES: The purpose of this study was to determine the effects of different psychoactive substances on serum biochemical parameters. PATIENTS AND METHODS: The study included 324 drug dependents, and 69 controls. The patient group was determined according to DSM-IV (The diagnostic and statistical manual of mental disorders, fourth edition) criteria. All patients and control subjects were tested for routine biochemical parameters and urine toxicology parameters for psychoactive substance use. Cases and controls with accompanying diseases like diabetes, cancer, metabolic disorders etc. are excluded from the study. Moreover, an association between urine toxicology results and changes in biochemical parameters was evaluated for statistical significance. RESULTS: There was a statistically significant difference in the Gamma-Glutamyl Transferase (GGT), uric acid, creatinine, urea, albumin, Aspartate Aminotransferase (AST) medians between the dependent and control groups (P < 0.05). We found a statistically significant difference in sodium and albumin levels between the opium-dependent and control groups (P < 0.05). In the benzodiazepin dependent group, we found a significant difference in GGT, urea, glucose, sodium, T protein, and AST levels (P < 0.05). Moreover, a statistically significant difference was observed in triglyceride and GGT levels between the ethyl glucuronide and control groups (P < 0.05). CONCLUSIONS: In psychoactive substance dependents, serum routine biochemistry parameters can be used to predict the need for intensive monitoring and treatment programs.

An outpatient clinical study of dissociative disorder not otherwise specified.

The relatively high prevalence of the diagnosis of dissociative disorder not otherwise specified is frequently considered to be disproportionate. The disproportionate rate of this diagnosis is thought to be related to nosologic and/or diagnostic issues in dissociative identity disorder. We sought to investigate and compare the symptom patterns of these two clinical entities. We conducted a cross-sectional study involving 1314 participants who were screened with the Dissociative Experience Scale (DES) and the Somatoform Dissociation Questionnaire (SDQ). Of the participants, 272 who scored above the cut-off points for the screening questionnaires (DES score>30 and/or SDQ score>40 points) were invited to complete a structured interview using the Dissociative Disorders Interview Schedule (DDIS); of this subsample, only 190 participants agreed to participate in the second phase of the study. The mean score for the DES was 18.55±17.23, and the mean score for the SDQ was 30.19±13.32. Of the 190 participants, 167 patients were diagnosed as having a dissociative disorder (87.8%). We found that DD-NOS was the most prevalent category of dissociative disorder. There was a significantly larger percentage of patients in the DID group than in the DD-NOS group according to secondary features of DID and Schneiderian symptoms. The secondary features of DID and Schneiderian symptoms appeared to be more specific for DID, while no differences were detected between DID and DD-NOS based on most of the items on the SCL 90R. Further longitudinal studies are needed to determine the features that are similar and dissimilar between DD-NOS and DID.

[Reliability and validity of the schedule for deficit syndrome in schizophrenia]. / Sizofreni'de Eksiklik Sendromu Cizelgesi (ESC)'nin Güvenilirlik ve Geçerlik Calismasi.

OBJECTIVE: The Schedule for Deficit Syndrome (SDS) is an instrument for categorizing schizophrenic patients as those with and without deficit syndrome. This schedule has been translated and adapted into the Turkish language in order to study its reliability and validity. METHOD: 30 male schizophrenic patients were included in the study. The patients had been ill for a long period of time and the course was continuous. The patients were assessed by two different raters using the SDS as a means of testing its reliability. A third rater assessed the same group of patients using the BPRS to test the validity of the SDS. RESULTS: The raters using the SDS demonstrated good inter-rater reliability for the categorization of patients with and without deficit syndrome, as well as for rating global severity (kappa: 0.88-0.93) and individual negative symptoms (kappa: 0.51-0.61). The schedule was also found to have a high validity for both categorization and measuring individual negative symptoms. (U: 60.0, P: 0.03). CONCLUSION: The results demonstrated that the Turkish version of the SDS would be a reliable and valid instrument that could be used in the study of schizophrenia.