Turkish Version of the Psychotropic Related Sexual Dysfunction Questionnaire (PRSEXDQ-T): Validity and Reliability in Patients Using Selective Serotonin Reuptake Inhibitor. / Psikotrop Iliskili Cinsel Islev Bozuklugu Ölçeginin Türkçe Versiyonu (PICIB-Türkçe): Seçici Serotonin Gerialim Inhibitörü Kullanan Hastalarda Geçerlik ve Güvenilirlik Çalismasi.

OBJECTIVE: Sexual dysfunctions (SD) are very common in patients with psychiatric disorders and may be due to the side effects of the disease or medications used. Current scales cannot distinguish whether SDs are due to psychiatric illness or medications use. The Psychotropic Associated Sexual Dysfunction Questionnaire (PRSexDQ) is a customized scale for screening SD due to drug use. Our aim is to conduct a validity and reliability study of PRSexDQ in patients using selective serotonin reuptake inhibitors (SSRIs). METHOD: One hundred patients who applied to psychiatry outpatient clinic and received SSRI treatment for at least 1 month were included in the study. These patients were evaluated by a psychiatrist, and completed the PRSexDQ-T, Arizona Sexual Experience Scale (ASEX), Golombok Rust Inventory Sexual Satisfaction (GRISS). RESULT: The Cronbach's Alpha coefficient was calculated as 0.906 for the analysis performed to evaluate the internal consistency of the PRSexDQ-T. In the item-total score analysis, the correlation of all items with the total score was found to be quite high (above 0.7). Correlation coefficients were found between 0.939 and 0.985, which was used to determine the test-retest correlation for each item, and all values were statistically significant (p<0.01). In the Pearson correlation analysis performed for validity analysis, a large positive correlation was found between PRSexDQ-T and ASEX and GRISS male-female total and subscale scores. CONCLUSION: The Turkish version of PRSexDQ is a valid and reliable measurement tool in the sample of patients using SSRIs to evaluate the level of sexual dysfunction.

Turkish Version of the Psychosis Attachment Measure: A Reliability and Validity Analysis.

Background: There is a need for a tool to assess the attachment in psychosis in the Turkish-speaking population. This study aims to evaluate the validity and reliability of the Turkish version of the Psychosis Attachment Measure of patients with schizophrenia. Methods: The sample of this study consists of 80 patients diagnosed with schizophrenia who have applied to a psychiatry outpatient clinic. Researches completed Positive and Negative Syndrome Scale and Calgary Depression Scale for schizophrenia. Patients were then asked to fill out the Psychosis Attachment Scale and Adult Attachment Style Scale by themselves. Results: The structure and content of the factor structure are suitable for the Turkish version (P < .001). In assessing the test-retest internal consistency for the Turkish version of Psychosis Attachment Measure, Cronbach's alpha values range from 0.738 to 0.922. The retest correlations for the subscales prove good retest reliability (P < .001). Conclusion: The findings show the Turkish version of the Psychosis Attachment Measure to be a reliable and valid measure for evaluating the attachment styles of patients with schizophrenia.

Retinal nerve fibre layer and peripapillary vascular density by optical coherence tomography angiography in schizophrenia.

Clinical relevance: Schizophrenia is a progressive disease. Analysis of retinal nerve fibre layer and peripapillary vascular density by optical coherence tomography angiography in schizophrenia patients may help to explain the pathophysiology of the disease.Background: Both macular and optic nerve microvascular structures can be visualised with optical coherence tomography angiography. Few studies have evaluated retinal vessels in patients with schizophrenia. Some of these studies suggest that larger retinal venules are associated with the severity of psychotic symptoms.Methods: This study evaluated retinal nerve fibre layer thickness and peripapillary vascular density by optical coherence tomography angiography in 22 eyes of 22 patients with schizophrenia and 26 eyes of 26 healthy control subjects. All peripapillary quadrants were evaluated with 4.5 × 4.5 mm images.Results: In the schizophrenia group, retinal nerve fibre layer thickness was significantly thinner and the mean peripapillary vascular density values were significantly lower in the temporal quadrant than in the control group (p < 0.05), but was similar in the peripapillary, superior, inferior, and nasal quadrants (p > 0.05). Peripapillary vascular density values and retinal nerve fibre layer thickness in schizophrenia patients were found to be lower in temporal quadrant compared to healthy eyes.Conclusion: Evaluation of the retina with optical coherence tomography angiography may be useful in detecting and monitoring progressive neurodegeneration in patients with schizophrenia.

Assessment of obsessive-compulsive disorder comorbidity and obsessive-compulsive symptom dimensions in patients with schizophrenia.

OBJECTIVES: To assess obsessive-compulsive disorder (OCD) comorbidity and obsessive-compulsive symptom (OCS) dimensions in patients with schizophrenia. METHODS: This cross-sectional study included 300 patients with schizophrenia who were applied to the to the Outpatient Psychiatry Clinic of Health Sciences University Diskapi Yildirim Beyazit Training and Research Hospital,  Ankara, Turkey between July and December 2018. Data collection forms created by researchers were applied to the individuals. Obsessive-compulsive symptom were assessed with the Yale-Brown Obsessive Compulsive Scale (YBOCS) and the Dimensional Obsessive Compulsive Scale (DOCS). RESULTS: The OCD prevalence was 17% (n=50) in the whole group while 10% (n=24/250) of the patients without OCD had 8-15 points at YBOCS. One-way ANOVA test revealed that the patients with OCD showed more severe positive, negative, and depressive symptoms, and also had lower functionality compared to those without OCD (p less than 0.05). The most severe OCS dimension was unacceptable obsessional thoughts in the patients with OCD and OCS. The severity of unacceptable obsessional thoughts was positively correlated with the depressive symptom severity, and negatively correlated with onset age of OCD and insight level in Pearson correlation analysis. CONCLUSION: Patients with schizophrenia should be evaluated for presence of the OCS/OCD comorbidity in clinical practice. In addition, dimensional assessment of OCS might provide a different viewpoint on the presence of OCS/OCD in schizophrenia.

A comparison of symptom dimensions for obsessive compulsive disorder and obsessive compulsive-related disorders.

OBJECTIVE: In this study, it is aimed to determine obsessive compulsive-related disorders (OCRDs) comorbidity among the patients with obsessive compulsive disorder (OCD) and compare patients with OCD with or without comorbid OCRDs in terms of the severity of their OCD symptoms, symptom dimensions, and comorbidity with other axis I disorders. METHODS: The study included 90 patients diagnosed as having OCD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria for OCRDs were used to determine the presence of OCRDs. In order to determine the symptom dimensions and severity of these individuals' OCD symptoms, we administered the Dimensional Obsessive Compulsive Scale (DOCS) and The Yale-Brown Obsessive Compulsive Scale (Y-BOCS). RESULTS: In our study, 20% of the patients with OCD simultaneously met the criteria for at least one OCRD, we also found that a significantly greater proportion of this group were men. None of the mentioned disorders was associated with any symptom dimensions we evaluated using DOCS. In addition, no differences were found in the severity of OCD symptoms and comorbid axis I disorders between the group with comorbid OCRDs and the group without comorbid OCRDs. DISCUSSION: There was no significant relationship between the symptom dimensions of OCD and OCRDs. It is found that OCRD comorbidity does not increase the severity of OCD symptoms and the prevalence of an axis I diagnosis.

Comparison of social supports for geriatric patients admitted to emergency department for trauma and medical reasons.

OBJECTIVES: Developments in medical technology have increased life expectancy around the world thereby, the population of elderly patients increases. While diagnosing the elderly patients, besides factors like physiological changes, comorbidities, multiple medications and admittance to the Emergency Department (ED) for serious causes, a lack of information and experience complicate the work of emergency physicians. Elderly people are admitted to ED with medical or traumatic complaints; nevertheless, independent of the reason for admittance to the ED their presenting condition should be simultaneously assessed for comorbidities. In this study, we aimed to compare social support and stress levels in geriatric patients admitted to the ED for trauma and medical reasons. METHODS: This was a single-center, prospective, descriptive, epidemiologic trial conducted in the ED of a training and research hospital between October 1st, 2015, and April 1st, 2016. Participants consisted 197 patients who were older than 65 years and presented to ED with medical reasons or trauma whose Emergency Severity Index (ESI) was ≥3. A socio-demographic and clinical data form, and the DUKE Social Support and Stress Scale (DUSOCS) were completed for each patient. RESULTS: Patients presenting with medical problems had higher family support levels than patients presenting with traumatic incidents, and this difference was statistically significant (p = 0.028). Concurrently, when both groups' family stress and social stress levels are viewed, patients presenting with trauma had higher levels of stress, and this difference was also statistically significant (p < 0.001). CONCLUSION: This study revealed that the patients admitted to the ED for trauma have lower social support levels than patients admitted for medical reasons. Moreover, social stress levels were also higher in these patients.

Chronic psychosis related to benzydamine hydrochloride abuse.

Benzydamine hydrochloride is a non-steroidal anti-inflammatory drug with analgesic and antipyretic effects. In those who use medicines containing this agent at high doses (500-3000 mg), some adverse effects such as hallucinosis, stimulant effects in the central nervous system, paranoia, and convulsions can be seen. The drug is vulnerable to abuse because of the stimulant effects on the central nervous system. In this paper, we present a young male patient with symptoms of psychosis due to benzydamine hydrochloride abuse. He was admitted to the psychiatry outpatient clinic with visual hallucinations, fear, and insomnia. His symptoms started after taking 10 tablets of benzydamine hydrochloride (500 mg) 6 months ago, which continued for 1-2 days and spontaneously resolved. The patient used high doses of the drug 3-4 times over a period of 3 months. Although his last drug intake was 3 months ago, his symptoms continued at the time of admission to the clinic. A neurologic examination and detailed laboratory tests of the patient revealed no evidence of a cause for psychotic symptoms. The patient was scheduled to undergo oral antipsychotic therapy. Although similar cases have been reported in the literature, this is the only case in which psychosis was still present despite discontinuation of the drug. Our aim was to contribute to the literature on the use of BH in causing chronic psychosis and to draw attention to the growing number of BH abuse cases.

[Dimensional Approach to Obsessive-Compulsive Disorder: Dimensional Obsessive-Compulsive Scale with Turkish Psychometric Properties]. / Obsesif Kompülsif Bozuklukta Boyutsal Yaklasim: Boyutsal Obsesif Kompülsif Bozukluk Ölçegi Türkçe’nin Psikometrik Özellikleri.

OBJECTIVE: The Dimensional Obsessive Compulsive Scale (DOCS) is a measurement tool that examines the severity of thematically distinct symptom domains of obsessive compulsive disorder (OCD). In this study we assess psychometric properties of the Turkish version of DOCS. METHODS: Ninety-six patients who presented consecutively to the Diskapi Yildirim Beyazit Teaching and Research Hospital outpatient unit and who were diagnosed with OCD according to the DSM-IV-TR criteria were enrolled in the study. The DOCS, Yale-Brown Obsessive Compulsive Scale (YBOCS), and Padua Inventory (PI) were completed by the participants. Internal consistency was estimated using Cronbach’s Alpha values and item-total correlations. Principal component analyses with Varimax rotation were used to assess latent factor structure . RESULTS: Explanatory Factor Analyses (EFA) revealed a 4-factor solution for the DOCS. Chronbach’s alpha values for the whole scale, “contamination” sub-scale, “responsibility” sub-scale, “unacceptable thoughts”, and “symmetry” sub-scales were 0.874, 0.932, 0.933, 0.948, 0.921, respectively. There was a high correlation between both total scores and sub-scales scores of DOCS, YBOCS and PI. CONCLUSIONS: Internal consistencies were good for the total scale and excellent for the sub-scales. The factor structure and the contents of the factors were perfectly in line with the original scale (i.e. 4 factor). Positive correlations between DOCS, its sub-scales, and similar OCD scales suggest that the DOCS accurately measures the structures it claims to assess. Thus the DOCS Turkish version can measure dimensional obsessive compulsive symptoms among the Turkish speaking OCD population.

A Neuroleptic Malignant Syndrome Without Rigidity.

Neuroleptic malignant syndrome (NMS) is an uncommon but potentially lethal idiosyncratic reaction which may emerge in the aftermath of the treatments with neuroleptics demonstrating itself with the symptoms of altered consciousness, high fever, impaired autonomic functions, and muscle rigidity. Although various risk factors have been identified for NMS, its etiology is not completely known. The mortality and morbidity related with NMS could be reduced by early diagnosis, interruption of the neuroleptics used within a short period and aggressive treatment. Our case is different from general NMS cases due to lack of rigidity. A NMS case which developed within a short time in the aftermath of multiple antipsychotic use and wherein no rigidity was observed shall be discussed in this case report.

Association of serum brain derived neurotropic factor with duration of drug-naive period and positive-negative symptom scores in drug naive schizophrenia.

INTRODUCTION: The aim of this study was to compare the serum brain derived neurotropic factor (BNDF) levels of patients with schizophrenia who had never received an antipsychotic treatment with those of a control group. Also, to analyze the relationship between the Positive and Negative Symptom Scale (PANSS) scores and BDNF levels of the patients during the period they were drug-naive. MATERIALS AND METHODS: The sample of the study comprised patients who presentedto the Psychiatry Clinic and were admitted after a distinctive schizophrenia diagnosis was made in accordance with the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) diagnosis classification and who were not using and never had any antipsychotic medicine. A total of 160 participants were included in the study, 80 of whom had schizophrenia patients and 80 constituted the age- and sex-matched healthy control group. Before the start of the treatment, the serum samples to be checked for the BDNF levels were collected from the patients. RESULTS: The difference between the average BDNF levels of the groups were statistically significant (t = -5.25; p˂.001). An analysis as to whether there was a relation between the BDNF levels and the drug-naïve duration indicated no correlations. An examination of the relationship between PANSS scores and BDNF levels of the patients yielded no correlations. DISCUSSION: Serum BDNF levels seem to be one of the indicators of schizophrenia and its progress; nevertheless, we still do not have sufficient information about this neurotropic factor. In light of our study, the neurodevelopmental changes that occur at disease onset of the illness prominently affect the progress of the illness, which highlights the importance of the treatment in the early stages.

The effectiveness of cognitive behavioral group psychotherapy for obsessive-compulsive disorder.

OBJECTIVE: The aim of this study was to determine the effectiveness of cognitive behavioral group therapy (CBGT) in the treatment of the obsessive-compulsive disorder (OCD). MATERIALS AND METHODS: The study included 82 patients diagnosed as OCD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). In all, 37 patients that had their diagnosis confirmed via the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and agreed to participate were provided group therapy as 14 weekly 90-120-min sessions. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Yale-Brown Obsessive Compulsive Scale-Symptom Checklist (Y-BOCS-SC), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were administered to the patients prior to group therapy (baseline) and again after sessions 2, 5, 8, 12, and 14. RESULTS: In all, 8 patients dropped out of the study for various reasons and 29 completed the group therapy. There were significant reductions in BAI, BDI, and Y-BOCS scores in the patients that completed the group therapy. Additionally, BAI, BDI, and Y-BOCS score did not differ according to age, gender, or level of education. CONCLUSIONS: CBGT was associated with significant improvement in OCD symptoms. Neither demographic characteristics (age, gender, and education level), nor clinical characteristics (disease duration, type of obsession, compulsion type, treatment history, and comorbidity pattern) had an effect on treatment outcome. In light of these findings, we think CBGT is an effective option for the treatment of OCD.

Comparison of personality beliefs between depressed patients and healthy controls.

INTRODUCTION: According to the cognitive model, the common mechanism underlying all psychological disorders is distorted or dysfunctional thoughts that affect mood and behaviors. Dysfunctional thoughts predispose an individual to depression and are among the processes that form the basis of personality traits. Elucidating the personality beliefs associated with depression and dysfunctional thoughts is important to understanding and treating depression. The aim of the present study is to determine whether depressed patients exhibited pathological personality beliefs compared with healthy controls. Furthermore, we investigated which personality beliefs were more common among such depressed patients. METHODS: A total of 70 patients who were admitted to the Department of Psychiatry at Ankara Diskapi Yildirim Beyazit Training and Research Hospital (Ankara, Turkey) and diagnosed with major depressive disorder according to The Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) diagnostic criteria were included in the study. Additionally, 70 healthy controls matched for age, marital status, and education were included in the study. The Sociodemographic Data Form and Personality Belief Questionnaire-Short form (PBQ-SF) were administered to the participants. RESULTS: A comparison of the depression group with the healthy controls revealed higher scores in dependent, passive-aggressive, obsessive-compulsive, antisocial, histrionic, paranoid, borderline, and avoidant personality subscales in the depressive group. CONCLUSIONS: These results suggest that personality beliefs at the pathological level are more common in depressive patients and that the detection of these beliefs would be useful for predicting the prognosis of the disease and determining appropriate treatment methods.