Addictive smartphone use in the elderly: relationship with depression, anxiety and sleep quality.

BACKGROUND: The aim of the present study was to explore the relationship between addictive smartphone use (ASU) and depressive symptoms, anxiety and sleep quality in elderly adults. METHODS: The study sample included smartphone users over the age of 65 years. The research data were obtained from social networking sites via a Google survey link. In addition to filling out a sociodemographic data form, the participants were also assessed with Smartphone Addiction Scale (SAS), Geriatric Depression Scale, Beck Anxiety Inventory and Pittsburgh Sleep Quality Index tools. RESULTS: The correlation analysis revealed the SAS score to be positively correlated with depression and anxiety, and negatively correlated with sleep quality. In the regression analysis, depressive symptoms, anxiety level and sleep quality were all found to have an effect on the SAS total score. Furthermore, the SAS score was found to have an effect on depressive symptoms, anxiety and sleep quality. CONCLUSIONS: Our findings reveal a bidirectional relationship between ASU and depressive, anxiety symptoms and impaired sleep quality in elderly adults. It is important to question smartphone use patterns in people with sleep problems, symptoms of depression or anxiety.

[Editorial: Telepsychiatry Throughout and Thereafter The Pandemic].

COVID-19 pandemisinin iki yili boyunca saglik hizmetlerine erisimin zorlasmasi saglik alanindaki tüm aktörlerin baslica gündem maddelerinden birini olusturdu. Pandemi sirasinda tüm toplu alanlarin, özellikle de saglik merkezlerinin riskli oldugu anlasildi. Ardindan psikiyatrik hastaligi olanlarin COVID-19 enfeksiyonuna yakalandiklarinda daha yüksek ölüm riski altinda olduklari da anlasildi (Nemani ve ark. 2021). Dolayisiyla bu grubun saglik merkezlerinde bulunmasi daha da büyük risk olusturacakti. Saglik hizmeti sunmak üzere kurulmus karmasik bir hizmet yapisinin saglik açisindan ciddi riskler barindirmasi gibi bir paradoks karsisinda hekimler ve meslek örgütleri temel etik ilkelere dönerek karar almak durumundaydilar: " zarar vermeme" ilkesi çerçevesinde acil ve ciddi saglik sorunlari haricinde saglik merkezlerine basvurulmamasi önerildi. Bu durum saglik hizmetlerinde ciddi aksamalara neden olacagi için, bu kez "yararlilik" ilkesi çerçevesinde telesaglik hizmetleri küresel çapta hizla yayginlasti. Telesaglik uygulamalari gerekli altyapidan yoksun ve saglik alaninda deneyim kisitli oldugu için saglik çalisanlari bir bakima el yordamiyla da olsa saglik hizmetlerini sürdürme yönünde inisiyatif aldilar. Tarihi, kavramsal olarak Sigmund Freud'un Küçük Hans vakasi, pratik anlamda ise 1964 yilinda Nebraska Üniversitesi ile 112 mil uzakliktaki Norfolk Kamu Hastanesi arasinda kurulan çift yönlü televizyon yayini ile baslatilabilecek olan telepsikiyatri (Artvinli ve Senyürek 2021), teknolojinin yayginlasmasina paralel olarak pandemi öncesinde de gittikçe yayginlasmaktaydi (Barnett ve ark. 2018). Pandemi basladiktan sonrasinda ise birçok ülkede telepsikiyatri görüsmeleri psikiyatri hizmetlerinde temel uygulama biçimini olusturmaya basladi (Mishkind ve ark. 2020). Ülkemizde de, bu yönde literatür verisi olmasa da, özellikle özel saglik hizmetlerinde telepsikiyatri uygulamalarinin yüz yüze görüsmelerinden daha yaygin biçimde kullanildigi gözlemlendi. Bunun yaninda kurumsal olarak Saglik Bakanliginin dr.enabiz.gov.tr sitesi üzerinden görüntülü görüsme uygulamasi, saglik çalisanlarina yönelik Türkiye Psikiyatri Derneginin Ruhsal Destek Hatti (Çapraz ve ark. 2020) ve Saglik Bakanliginin RUHSAD projesi (Hacioglu 2020), Istanbul Il Saglik Müdürlügü tarafindan koordine edilen KORDEP (Bilici 2020) gibi telepsikiyatri projeleri gerçeklestirildi.. Telepsikiyatride ideal uygulamanin nasil olacagi ile ilgili pandemi sirasinda çesitli kilavuzlarin gerekliligine vurgu yapildi ve birçok ülkede kilavuzlar yayinlandi ya da güncellendi (Li ve ark. 2021). Türkiye Psikiyatri Dernegi de meslektaslara yönelik kilavuzlar hazirlamanin sorumlulugu ile pandemiden önce yayinladigi telepsikiyatri metinlerine ek olarak, genis kapsamli Telepsikiyatri Uygulama Rehberini internet sitesinde açik erisimli olarak yayinladi (Karas ve ark. 2022). Vaka sayilarinin son zamanlarda azalmasi ve mortalitenin düsüse geçmesi ile birlikte kisitlamalar da Türkiye dahil olmak üzere çogu ülkede hafifletildi. Dolayisiyla telepsikiyatriye olan gereksinim pandemi disindaki gerekçelerle devam ediyor olsa da pandemi dönemindeki düzeyde degildir. Çalismalar her ne kadar telepsikiyatri ile ilgili hasta ve hekim memnuniyetinin yüksek ve etkinligin yüz yüze uygulamalara denk oldugunu gösterse de uygulama ile ilgili kuskular henüz tamamen ortadan kalkmis degil. Bu konuda meslek örgütleri yüz yüze görüsmenin altin standart oldugu ve yararlilik ilkesi geregince öncelikli olarak tercih edilmesi gerektigini vurgulamaktadir (Dünya Tabipler Birligi 2018, Türk Tabipleri Birligi 2021). Dolayisiyla telepsikiyatrinin pandemi sonrasinda hangi Gelis Tarihi: 27.05.2022, Kabul Tarihi: 07.06.2022, Çevrimiçi Yayin Tarihi: 16.06.2022 1 Dr. Ögr. Üyesi, Istanbul Gelisim Üniv. Psikoloji Bl., Istanbul, 2 Uzm., Serbest Hekim, Istanbul. HK: https://orcid.org/0000-0002-9391-5415, IK: https://orcid.org/0000-0002-9073-0079 Dr. Hakan Karas, e-posta: hakankaras@yahoo.com https://doi.org/10.5080/u27177 A4 durumlarda uygulanabilecegi sorusu üzerine daha çok düsünmemiz gerekiyor. Telepsikiyatrinin pandemi sonrasindaki kullanimini etik açidan gözden geçirirken "yararlilik" ilkesine farkli baglamlarda deginmek gerekecektir. Yüz yüze hizmetin altin standart oldugu göz önüne alindiginda telepsikiyatri hizmetinin yüz yüze psikiyatrik hizmete erisebilen hastalara önerilmesinin "yararlilik" ilkesi ile çelisebilecegi akilda tutulmalidir. Yine, "yararlilik" ilkesi çerçevesinde özellikle saglik hizmetlerine erisimi sinirli olabilen engelli bireyler, peripartum dönemdeki kadinlar ve hastalara bakim veren kisiler için potansiyel kullanim alani olabilir. Ayrica kirsalda cografi nedenlerle psikiyatriste yeteri kadar ulasamayan kisiler veya Toplum Ruh Sagligi Merkezleri gibi toplum temelli uygulamalarda daha etkin ulasim için telepsikiyatri olanak sunmaya devam edebilir. Afet ve travmaya iliskin bilgi ve deneyim birikimi sonraki kitlesel travmalara da aktarilabilir. Ayrica istemli ya da istemsiz biçimleriyle göçün oldukça yayginlastigi bir dönemde ve cografyada bulunma sebebiyle, ana dilde hizmet alma gereksiniminin oldugu durumlarda da telepsikiyatri önemli bir seçenek olabilir. Bundan sonraki süreçte "özerklik" ilkesi de göz ardi edilmemelidir. Hastanin fiziksel durumu veya konumu ne olursa olsun telepsikiyatri hizmetinin dayatilmamasi ve ancak bir seçenek olarak sunulabilir olmasi gerekmektedir. Özerklik ilkesi tersi durum için de geçerlidir. Telepsikiyatri uygulamalarinin avantaj ve dezavantajlari tarif edilip, yüz yüze uygulamanin altin standart oldugu net biçimde belirtildikten sonra karar verme yetisine sahip her hasta telepsikiyatri hizmetini tercih edip etmeyecegi konusunda özerk biçimde karar alabilmelidir. Yine bu ilke dogrultusunda telepsikiyatri hizmetinden yararlanma karari vermis bir hastanin kararini herhangi bir asamada degistirmis olmasindan dolayi bir hak kaybina ugramayacaginin da temin edilmesi gerekmektedir. "Zarar vermeme" ilkesini gözetirken hastanin görüsme sirasinda hem teknoloji hem de fiziki kosullar açisindan mahremiyetini koruma kapasitesinin olup olmadigi degerlendirilmelidir. Bu gibi durumlarda kurum içi telepsikiyatri uygulama olanaklari göz önüne alinabilir. Örnegin afet durumlarinda çadir kentlerde saglik görüsmeleri için ses izolasyonu saglanmis görüsme odalari bu amaçla kullanilabilmektedir. Ayrica teknolojik temalari içeren sanrilari olan hastalarda telepsikiyatrik hizmetlerin bu sanrilari alevlendirme riski de göz önünde bulundurulmalidir. Hekimligin diger bir temel ilkesi olan "adalet" de telepsikiyatri uygulamalarini degerlendirmede bir unsur olmalidir. Telepsikiyatrik hizmetle ilgili karar verme sürecinde hastanin saglik hizmetine hiç ulasamamasi kadar "yeterince" ulasamama durumu da göz önünde bulundurulmalidir. Kirsalda yasayan bir hastanin hastaneye ulasimi olsa da yeterince sik olamayisi, örnegin taburculugunda bir hafta sonra ayaktan kontrolüne gelebilen sehirde yasayan bir hastaya göre daha kötü hizmet almasi ve belki de daha fazla ilaç yan etkisi yasamasi ile sonuçlanabilir. Bu gibi durumlarda telepsikiyatri uygulamalari ile yüz yüze görüsmeleri birlikte barindiran, yapilandirilmis melez modeller ile saglik hizmeti sunumunda adalet ilkesi kismen de olsa tesis edilebilir. Bu dogrultuda bir telepsikiyatri uygulamasi yapilandirilirken de hedef kitlenin saglik hizmetine ulasmakta zorlanan dezavantajli gruplardan seçilmesi gerekmektedir. Yine de bu dezavantajli gruplarin saglik hizmetine ulasmakta zorlandiklari gibi telepsikiyatri uygulamalarinda gerekli teknolojiye de ulasmakta (örnegin kirsal bölgelerde bant genisligi ve internet baglanti hizlarinin düsük olusu) ya da kullanmakta da (örnegin bedensel engellilik nedeniyle teknolojik cihazlari kullanmakta zorlanma) zorlanabilecekleri akilda tutulmali, uygulamalar bu unsurlari da göz önüne alarak hazirlanmalidir. Sonuç olarak telepsikiyatri uygulamalari pandemi döneminde bir zorunluluk olarak mesleki pratigimize girmis olsa da pandeminin bitmesi ile telepsikiyatriye olan gereksinim ortadan kalkmamistir. Bu yeni ve uzun vadede sonuçlari henüz tam olarak bilinmeyen uygulama alaninda psikiyatristler temel etik ilkeleri gözönüne almaya devam ettikleri sürece güvenli ve etkili biçimde hizmet sunmaya devam edebilirler. KAYNAKLAR Artvinli F, Senyürek G (2021) Yakin gelecegin uzak geçmisi: Telesaglik tarihi. Telesaglik Temel Basvuru Kitabi içinde (Küçükparlak I, Karas H., Editörler), Nobel Tip Kitabevleri, s. 3-29 Barnett ML, Ray KN, Souza J ve ark. (2018) Trends in telemedicine use in a large commercially insured population, 2005­2017. JAMA 320:2147­79. Bilici R (2020) Istanbul Koronavirüs Ruhsal Destek Programi: KORDEP'e bir bakis. TPD Bülteni, 23:1 Capraz N, Erim BR, Kucukparlak I ve ark. (2020) A specific mental health intervention for healthcare workers in Turkey. Asian J Psychiatr 54: 102315. Dünya Tabipler Birligi (2018) Teletip Etigiyle Ilgili Dünya Tabipler Birligi Açiklamasi. 27 Mayis 2022'de https://www.ttb.org.tr/userfiles/files/dtb_ teletip.pdf adresinden indirildi Hacioglu Yildirim M (2020) RUHSAD: Saglik Bakanligi Saglik Çalisanlari ve Çocuklari Için Ruhsal Destek Sistemi. TPD Bülteni, 23:1 Karas H, Küçükparlak I, Erkan A ve ark. (2022) Telepsikiyatri Uygulama Rehberi. Türkiye Psikiyatri Dernegi Yayinlari Li H, Glecia A, Kent-Wilkinson A ve ark. (2022) Transition of mental health service delivery to telepsychiatry in response to COVID-19: a literature review. Psychiatr Q 93: 181-97. Mishkind M, Shore JH, Bishop K ve ark. (2020) Rapid conversion to telemental health services in response to COVID-19: experiences of two outpatient mental health clinics. Telemed e-Health 27: 778-84 Nemani K, Li C, Olfson M ve ark. (2021) Association of Psychiatric Disorders With Mortality Among Patients With COVID-19. JAMA Psychiatr 78:380­86. Türk Tabipler Birligi (2021) Teletip Uygulamalarina Yönelik Türk Tabipleri BirligiEtik Kurulu Görüsü. 27 Mayis 2022'de https://www.ttb.org.tr/ haber_goster.php?Guid=c0766012-4f83-11eb-b1e9-666ef27369b5 adresinden indirildi

Changes in telepsychiatry regulations during the COVID-19 pandemic: 17 countries and regions' approaches to an evolving healthcare landscape.

BACKGROUND: During the COVID-19 pandemic, the use of telemedicine as a way to reduce COVID-19 infections was noted and consequently deregulated. However, the degree of telemedicine regulation varies from country to country, which may alter the widespread use of telemedicine. This study aimed to clarify the telepsychiatry regulations for each collaborating country/region before and during the COVID-19 pandemic. METHODS: We used snowball sampling within a global network of international telepsychiatry experts. Thirty collaborators from 17 different countries/regions responded to a questionnaire on barriers to the use and implementation of telepsychiatric care, including policy factors such as regulations and reimbursement at the end of 2019 and as of May 2020. RESULTS: Thirteen of 17 regions reported a relaxation of regulations due to the pandemic; consequently, all regions surveyed stated that telepsychiatry was now possible within their public healthcare systems. In some regions, restrictions on prescription medications allowed via telepsychiatry were eased, but in 11 of the 17 regions, there were still restrictions on prescribing medications via telepsychiatry. Lower insurance reimbursement amounts for telepsychiatry consultations v. in-person consultations were reevaluated in four regions, and consequently, in 15 regions telepsychiatry services were reimbursed at the same rate (or higher) than in-person consultations during the COVID-19 pandemic. CONCLUSIONS: Our results confirm that, due to COVID-19, the majority of countries surveyed are altering telemedicine regulations that had previously restricted the spread of telemedicine. These findings provide information that could guide future policy and regulatory decisions, which facilitate greater scale and spread of telepsychiatry globally.

Associations of depressive symptoms and perceived social support with addictive use of social media among elderly people in Turkey.

BACKGROUND: The aim of this study was to investigate the relationship of addictive use of social media (AUSM) with depressive symptoms, perceived social support and demographic variables among people aged 65 years and older. METHODS: People aged 65 years and older who use social media constituted the study sample. The data were obtained from social networking sites via Google survey link. Bergen social media addiction scale (BSMAS) for determining AUSM, Multidimensional Scale of Social Support for determining social support, Geriatric Depression Scale to identify depressive symptoms and sociodemographic data form were administered to the participants. RESULTS: The mean age of the sample was 68.86 ± 2.0 years. AUSM showed significant differences depending on gender, marital status, economic status, educational level, settlement, occupation, and time spent in social media (P = 0.00). AUSM had correlations with both sub-dimensions of perceived social support and depressive symptoms (P < 0.01). In the regression analysis, it was found that the depressive symptoms, social support from family (P = 0.00) and from a significant other (P = 0.001) had significant effects on AUSM. CONCLUSIONS: When evaluating elderly individuals with depressive symptoms, it is important to evaluate these individuals in terms of social media addiction. Interventions to improve social support systems, especially for older people with little perceived social support can help prevent the development of AUSM.

Associations of Attachment and Coping Styles With Social Functioning in Patients With Bipolar Disorder I.

ABSTRACT: The aim of this study was to investigate the relationship of attachment and coping mechanisms with social functioning in patients with bipolar disorder (BD). Sixty-three patients with BD type I and 63 healthy controls were evaluated. Structured Clinical Interview for DSM-IV Axis I Disorders, Hamilton Depression Rating Scale, Young Mania Rating Scale, Experiences in Close Relationships Questionnaire II, Coping Orientation to Problems Experienced (COPE) inventory, and Social Functioning Scale were used. In the BD group, adaptive coping style scores and attachment avoidance scores were significantly lower than the control group, but mean scores of maladaptive coping styles were higher than the control group. Regression analysis showed that positive reinterpretation and growth, active coping, use of emotional social support, planning, religious activities, and mental disengagement subscales of COPE were significantly associated with social functioning. Psychosocial interventions to strengthen adaptive coping mechanisms may help improve the social functioning in patients with BD.

The Relationship of Theory of Mind and Attachment Characteristics with Disease Severity in Social Anxiety Disorder.

INTRODUCTION: The aim of our study is to compare the attachment characteristics and the theory of mind abilities measured by the Eyes Test between social anxiety disorder (SAD) patients and healthy controls. Another aim of our study is to investigate the relationship between attachment characteristics, theory of mind abilities and disease severity in patients with SAD. METHOD: 47 consecutive patients with SAD and 50 healthy controls were recruited for the study. Sociodemographic data form, SCID-I Structured Clinical Interview form Patient Version, Beck Depression Inventory (BDI), Reading Mind in the Eyes Test (Eye Test), Liebowitz Social Anxiety Scale (LSAS), Experiences in Close Relationship Inventory (ECR) and State-Trait Anxiety Inventory (STAI) were administered to all participants. RESULTS: The BDI, LSAS anxiety and avoidence, ECR and anxiety and avoidance, STAI state and trait anxiety scores of the SAD group were higher than the controls, but the Eyes Test scores were lower. It was observed that the Eyes Test score difference between the two groups survived when controlled for BDI and STAI state and trait anxiety scores. In the SAD group, both ECR anxiety and avoidance scores were associated with LSAS anxiety and avoidance scores. Eyes Test scores were associated with LSAS anxiety and avoidance scores. In regression analysis, it was observed that the Eyes Test, ECR anxiety and avoidance scores effected both the LSAS anxiety and the LSAS avoidance scores. CONCLUSION: In SAD patients, the theory of mind functions was impaired when compared to healthy controls, and this difference has been found to be independent of anxiety or depression levels. Attachment anxiety and avoidance dimensions have negative effects on SAD disease severity. The fact that the theory of mind ability is inversely related with SAD severity suggests that interventions to improve social cognition might have a potential to decrease the severity of disease in SAD.

Childhood and adult attention deficit hyperactivity disorder symptoms in fibromyalgia: associations with depression, anxiety and disease impact.

Objective: The first aim of this study was to determine the prevalence of childhood and current attention deficit hyperactivity disorder (ADHD) symptoms in patients with fibromyalgia. The second aim is to assess the role of depression and anxiety on the relationship between childhood and adult ADHD symptoms with disease impact in this population.Methods: Sixty-four patients with fibromyalgia were compared to matched 58 healthy controls. All participants completed the Wender Utah Rating Scale (WURS), Adult ADHD Self-Report Scale (ASRS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Fibromyalgia Impact Questionnaire (FIQ).Results: Patients with fibromyalgia had significantly higher mean scores of depression (BDI), anxiety (BAI), childhood ADHD symptoms (WURS) and adult ADHD symptoms (ASRS total, ASRS hyperactivity/impulsivity subscale and ASRS attention deficit subscale) than the control group. Fibromyalgia impact (FIQ) was significantly correlated with depression (BDI; r = 0.57, p < .001), anxiety (BAI; r = 0.56, p < .001) and childhood ADHD symptoms (WURS; r = 0.41, p < .001) in fibromyalgia group. There was no significant correlation between fibromyalgia impact (FIQ) and adult ADHD symptoms (ASRS total or sub-scale scores). Hierarchical multiple regression indicated that childhood ADHD symptoms (WURS), anxiety (BAI) and depression (BDI) predicted fibromyalgia impact. Both anxiety (BAI) and depression (BDI) mediated the relationship between childhood ADHD symptoms (WURS) and fibromyalgia impact (FIQ).Conclusion: Childhood ADHD symptoms may be a contributory factor to poorer functioning in the patients with fibromyalgia. The relationship was more pronounced in the presence of depression and anxiety symptoms. Evaluation of childhood and adult ADHD symptoms in patients with fibromyalgia is important for recognition and treatment of ADHD comorbidity and also for attenuating the severity of the disease.

[Use of Modafinil in Co-existing Major Depression and ErectileDysfunction: A Case Report]. / Sertlesme Bozuklugunun Eslik Ettigi Majör Depresyonda Modafinil Kullanimi: Bir Olgu Sunumu.

Erectile dysfunction is a sexual dysfunction which is commonlycomorbid with major depression. Antidepressant treatment does notalways improve comorbid sexual dysfunctions in major depression. Infact, sexual dysfunction may worsen or get complicated following theintroduction of antidepressants. Modafinil is a drug with stimulanteffect on the central nervous system by binding to norepinephrineand dopamine transporters and consequently increasing synapticnorepinephrine and dopamine levels. Modafinil is primarily used inthe treatment of narcolepsy and chronic fatigue syndrome. In addition,it is known for its effectiveness in attention deficit hyperactivitydisorder and as an add-on option for major depression. In this paper,we report the case of a 39-year-old man with major depression whosecomorbid erectile dysfunction improved after addition of modafinilto antidepressant treatment. Fluoxetine 20 mg/day was initiatedand despite the improvement of most of the depressive symptomsand the sexual desire, his complaints of fatigue, weakness and erectiledysfunction continued. With the addition of modafinil (200 mg /day),improvement was observed not only in psychomotor symptoms but alsoin erectile dysfunction of the patient.

Loss of Sight Caused by Ocular Self-Mutilative Behaviour: A Case of Malignant Tourette Syndrome.

Tourette's Syndrome is developmental neuropsychiatric disorder characterized by stereotypic, non-rhythmic multiple motor and/or vocal tics. In rare cases, severe tics which can be life-threatening or self-mutilating may be observed in Tourette Syndrome. These types of cases that involve severe self-injurious behavior are called malignant Tourette's Syndrome. In this report, we present an adult case of Tourette Syndrome with vision loss as a result of recurrent and severe ocular self-mutilative tics.

[Prevalence of Depression and Anxiety Disorders and Their Relationship with Sexual Functions in Women Diagnosed with Lifelong Vaginismus]. / Yasam Boyu Vajinismus Tanisi Konulan Kadinlarda Depresyon ve Anksiyete Bozukluklarinin Yayginligi ve Cinsel Islevlerle Iliskisi.

OBJECTIVE: In patients with vaginismus, the Lack of knowledge on rates of depression and anxiety disorders is noteworthy. The aim of the present study was to investigate the prevalance of anxiety disorders and major depression and to examine the relationship of these  omorbidities with sexual functions in women diagnosed with lifelong vaginismus.  METHOD: One hundred and fourty-four women who were diagnosed with vaginismus were recruited for the study. Depression and anxiety disorders section of the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and Golombok-Rust Inventory of Sexual Satisfaction (GRISS) were administered to the participants.  RESULTS: At least one comorbid anxiety disorder and/or depression was found in 79.86 % of the cases. The most common comorbid disorder was specific phobia (63.9%). This was followed by major depression (35.4%), social anxiety disorder (13%), panic disorder (10%), obsessive compulsive disorder (5%) and generalized anxiety disorder (2%). On GRISS, mean avoidance score was higher in patients with comorbid depression and non-communication score was higher in patients with comorbid panic disorder when compared to patients with no comorbidity.  CONCLUSION: The prevalence of depression and anxiety disorders, especially spesific phobia, was higher in patients with vaginismus than the general population. Both high comorbidity of these psychiatric disorders and disruption of functions in all domains of sexuality emphasize the importance of holistic approach in evaluation of these patients.

Withdrawal-Emergent Dyskinesia and Supersensitivity Psychosis Due to Olanzapine Use.

Tardive dyskinesia (TD) usually appears after years of antipsychotic drug use and appears to be related to the total lifetime medication dose. In withdrawal-emergent dyskinesia (WE-D), which is considered to be a subtype of TD, dyskinetic symptoms often appear shortly after a rapid reduction in antipsychotic drug dose or sudden discontinuation of the drug. Supersensitivity psychosis, which is frequently observed along with TD and is considered to have a similar etiology as TD, is a psychotic relapse phenomenon that occurs after the withdrawal of an antipsychotic drug or a rapid reduction in the drug dosage. In general, atypical antipsychotics tend to be associated with less propensity to cause TD when compared with typical antipsychotics. Furthermore, olanzapine and clozapine may have a therapeutic potential in improving or totally curing TD. In this study, a case of WE-D because of discontinuing olanzapine use and supersensitivity psychosis is discussed.