The Association of Child Abuse Experiences and Intolerance of Uncertainty in Young Adults.

Objective: Drawing upon the identity disruption model, we investigated the association between child abuse experiences (emotional, physical, and sexual) and intolerance of uncertainty. We also addressed demographic differences in uncertainty intolerance in this study. Methods: Using online survey questionnaires, we collected data from a sample of 302 young adults in Turkey. The data were analyzed using confirmatory factor analysis, structural equation modeling, one-way analysis of variance, and independent samples t-test. Results: The results showed that of the three types of child abuse analyzed, only emotional abuse was significantly and positively associated with intolerance of uncertainty. In contrast, age was negatively associated with intolerance of uncertainty. Regarding demographic differences, we found that the level of intolerance of uncertainty differed based on young adults' gender, psychiatric diagnosis, and education. Specifically, our findings indicated that intolerance of uncertainty is significantly higher in females compared to males. It is also significantly higher in young adults with a diagnosis for psychiatric disorders than those without. Moreover, intolerance of uncertainty is significantly higher in young adults who have a high school graduate degree than their undergraduate and graduate counterparts. We discussed how child abuse is associated with heightened intolerance of uncertainty in young adulthood as well as why demographic differences may exist in uncertainty intolerance. Conclusions: The present study expanded the existing research on the psychological consequences of childhood abuse experiences by linking child abuse to intolerance of uncertainty. Particularly, exposure to emotional abuse in early life can be a risk factor to cope with uncertainty in later life.

A Randomized-Controlled Trial of EMDR Flash Technique on Traumatic Symptoms, Depression, Anxiety, Stress, and Life of Quality With Individuals Who Have Experienced a Traffic Accident.

The Flash Technique of Eye Movement Desensitization and Reprocessing (EMDR) is widely recognized for its effectiveness in reducing the effects of emotional responses associated with traumatic memories. Using a randomized-controlled trial methodology, this study attempts to establish the efficacy of the EMDR Flash Technique. This study's sample includes volunteers who were involved in traffic accidents and were given the randomized EMDR Flash Technique and Improving Mental Health Training for Primary Care Residents (mhGAP) Stress management module. The participants were given a socio-demographic data form, the Depression-Anxiety-Stress 21 scale (DASS-21), the Impact of Event Scale-Revised (IES-R), and the WHOQOL Quality of Life scale. Participants were evaluated using measurements taken before and after the application, as well as a one-month follow-up. The mean age of the participants was 36.20 (11.41) years and 82.1% (n = 32) were female. The DASS-21 Anxiety (η 2 = 0.085), IES-R Intrusion (η 2 = 0.101), Avoidance (η 2 = 0.124), Total (η 2 = 0.147), and WHOQOL-BREF Psychological (η 2 = 0.106) score improvements of the EMDR Flash Technique group were shown to be statistically significant when compared to the mhGAP group. However, no statistically significant difference in the DASS-21 Depression, Stress, Impact of Event Scale-Revised Hyperarousal WHOQOL-BREF General Health, Physical, Social Relationships, and Environment component scores was reported between the two groups. The present study's findings clearly demonstrate that the EMDR Flash technique, when applied to persons involved in traffic accidents, is successful in improving anxiety, intrusion, avoidance, total traumatic stress, and mental quality of life symptoms for at least 1 month. We believe that these findings will improve the reliability and applicability of the EMDR Flash Technique, which was tested for the first time in a clinical randomized-controlled trial (RCT).

Effects of childhood psychological trauma on rheumatic diseases.

OBJECTIVE: The etiology of rheumatic diseases is unclear, but it is thought that environmental factors added to immunogenetic mechanisms in chronic inflammatory diseases play a role. Many inflammatory disorders, autoimmune diseases, and painful conditions have been shown to be associated with the psychological trauma of childhood. The aim of the present study was to investigate childhood psychological trauma that is considered to be one of the environmental factors that initiate inflammation on patients with rheumatic diseases. METHODS: In our study, a total of 440 patients (220 patients who have rheumatic diseases as the case group and 220 patients who have no rheumatic disease as the control group) were examined. The Childhood Trauma Questionnaire-28 (CTQ-28) was administered and was completed by the patients. This was a cross-sectional study design. RESULTS: No statistically significant differences were found between the case and control groups with respect to age, gender, marital status, and educational level. The CTQ-28 scale was found to be significantly higher in patients with rheumatic diseases (ankylosing spondylitis, rheumatoid arthritis, and connective tissue disease) in our study. CONCLUSION: We think that childhood psychiatric traumas are effective in the etiopathogenesis of rheumatic diseases. To make this relationship more understandable, multidisciplinary research and long-term follow-up studies are needed to examine neuroendocrine, genetic, and epidemiological factors.

[Eye Movement Desensitization and Reprocessing (EMDR) Therapy on a Patient with Schizophrenia and Clinical Effects: A Case Study]. / Sizofreni Olgusunda Göz Hareketleri ile Duyarsizlastirma ve Yeniden Isleme (EMDR) Uygulamasi ve Klinige Etkileri: Olgu Sunumu.

Being exposed to traumatic experiences is rather common in patients with schizophrenia. Adverse experiences may induce the onset of psychotic symptoms or trigger current symptoms to be exacerbated. Eye Movement Desensitization Reprocessing (EMDR) is an effective therapy in the treatment of incidences with underlying traumatic experiences, there by it can be conducted on various cases in addition to other treatments such as psycho-medication or another therapy method. It was developed by Shapiro in 1980s. Although desensitization is widely applied on patients with Post-Traumatic Stress Disorder, it is unusual for EMDR therapy to be safely and effectively performed in the treatment of psychotic disorder sor symptoms. In the present case study, EMDR treatment process and course of psychiatric state in a patient with history of child hood abuse and forced psychiatric residency will be discussed. The patient who had a diagnosis of schizophrenia for 8 years was treated with antipsychotic treatment as well as 2 sessions of EMDR, and as a result, a positive change was observed in her general clinical course. Our thoughts on this phenomenon are that EMDR treatment is an effective, safe and short-term intervention in the comorbidity of PTSD and psychotic disorders. However, the literature about the place of EMDR in the treatment of schizophrenia cases is rather limited and much more research is needed.

[The Relationship Between Anger Expression, Body Image and Eating Attitudes in Social Anxiety Disorder]. / Sosyal Anksiyete Bozuklugunda Öfke Ifadesinin Beden Imgesi ve Yeme Tutumu ile Iliskisi.

OBJECTIVE: The aim of the present study was to investigate both the prevalence of social anxiety disorder (SAD) and itsassociation of trait anger and anger expression, eating attitudes and body perceptions in university students having the said disorder. METHOD: One thousand students from Cumhuriyet University were included in the study. During the initial stage, Liebowitz Social Anxiety Scale (LSAS) and socio-demographic data form were administered to the students. Those obtaining 30 points or more in LSAS were called for a psychiatric interview. The students diagnosed with social anxiety disorder (n=87) and the control group (n=87) were administered Eating Attitude Test (EAT), Multidimensional Body-Self Relations Questionnaire (MBSRQ) and The State Trait Anger Scale (STAXI). RESULTS: The point prevalence of social anxiety disorder was found to be 9.4% in those attending the study. Trait anger, anger-in and anger-out scores were statistically significantly higher; anger control and multidimensional body-self relations scale points were statistically lower at the SAB group when compared to the control group. The MBSRQ scores correlated negatively, while the EAT scores correlated positively, with anger-in scores in students with SAD. CONCLUSION: SAD is a common disorder in university students. Our study, showed that repressed anger could adversely affect body image and eating behaviors in SAD. In students having social anxiety disorder, approaches aiming at appropriate anger expression and positive body perception may yield positive results to treatment in students with SAD.

Paliperidone: As a Possible Cause of Pericardial Effusion.

Paliperidone which is the active metabolite of risperidon is one of the novel antipsychotics. Controlled clinical studies proved its effectiveness on decreasing the positive and negative symptoms of schizophrenia. Some studies and case reports, reported its cardiovascular and cardiometabolic side effects. Cardiac tamponade, that may be mortal, wasn't reported as a side effect with paliperidone usage before. We present a 40 years old female with catatonic schizophrenia for eighteen years, whom was on 6 mg/day paliperidon for 3 years and presented with pericardial tamponade. We suggest that paliperdione may have cardiovascular and cardiometabolic side effects also in therapeutic doses.

[The prevalence of eating disorders and comorbid psychiatric disorders in the Sivas Province]. / Sivas Il Merkezinde Yeme Bozukluklarinin Yayginligi ve Eslik Eden Psikiyatrik Tanilar.

OBJECTIVE: The purpose of this study was to determine the prevalence of eating disorders (EDs) in the Sivas province, and to identify the sociodemographic characteristics and co-morbid axis-I and axis-II diagnoses in EDs. METHOD: 1122 people between 18-44 years of age were enrolled in the study after completing the eating attitude test (EAT), and people who had points around the cut-off score had clinical interviews. The control group included subjects that were age- and sex-matched with the ED group, were not diagnosed with an ED, and had an EAT score <30. In order to determine the following as axis I or axis II, SCID-I (Structured Clinical Interview for DSM-IV Axis-I Disorders) and SCID-II (Structured Clinical Interview for DSM-III-R Personality Disorders) were performed on both the eating disorder and control groups. RESULTS: As a result of the scanning done with EAT, we observed that 5.25% of this population might have an eating behavior disorder. The prevalence of the eating disorders was found to be 1.52% by the structured clinical interview in the second step of the study. While the prevalence of bulimia nervosa was determined to be 0.63%, that of binge eating disorder was 0.81%. The diagnosis of ED is common and statistically significant among women (88.2%). According to the study, persons diagnosed with ED were more likely to have a moderate income as compared with those who were not diagnosed with an ED. Also, people with ED had been exposed to more traumas, and it was more likely that someone in their family had a psychiatric diagnosis. Among the patient group, the axis I and axis II co-morbidity rates were significantly higher than those of the control group. 47% (8/17) of the patients were determined to have a co-morbid axis I diagnosis. The most frequently diagnosed co-morbidity was major depressive disorder. 41% of the patients were determined to have an axis II diagnosis. The most common rate of diagnosis was 11.8% for both obsessive-compulsive personality disorder and avoidant personality disorder. CONCLUSION: The results of this study show that the point prevalence rate for EDs among all the participants was 1.52%, with binge eating disorder being the most prevalent ED. Psychiatric co-morbidity is common in patients with eating disorders. An ED is a disease that can be seen in different age groups and socioeconomic levels. Studies with larger samples, including different regions of the country and different age groups, and with diagnoses that have been confirmed by clinical interviews, are required.

Assessing anxiety levels and empathic tendency in blood and platelet donors.

In spite of a constantly-increasing requirement for blood transfusion in the world, blood donation does not exhibit an increase at the same rate. In Turkey with a population of 74 million, only 15 per 10,000 people donate blood regularly and rate of voluntary blood donation is very low compared to developed countries. The aim of this study is to determine empathic level of donors and anxiety levels of blood and platelet donors and also to enable comfort and motivation of donors by taking precautions for reducing their anxieties. This prospective and descriptive study was conducted with 100 voluntary donors (50 blood donors, 50 platelet donors) who admitted to Blood Centre of Cumhuriyet University Hospital between 15 March 2012 and 30 April 2012. Average age of these donors was 27 (19-48)years. The mean scores of donors from Empathic Tendency Scale (ETS), State Anxiety Invertory (SAI) and Trait Anxiety Inventory (TAI) were 70 (49-83), 40 (33-45) and 34 (30-44), respectively. ETS score of those donating blood/platelet for the first time was low, >1 is higher in those who donated previously. SAI and TAI scores of blood donors were higher than those of platelet donors (p<0.001) and TAI score was higher in those who donate for the first time (p<0.007) compared to previously donated precipitants. In conclusion, this study underscores that the request of the donor to help others is the most important factor for donation. People frequently donate blood to unfamiliar people and recurring blood donations increase the level of empathy. Donation made during the continuous disclosure is an important factor for being a donor.

Prevalence of migraine and co-morbid psychiatric disorders among students of Cumhuriyet University.

BACKGROUND: The aim of this study was to investigate the prevalence of migraine and associated psychiatric disorders among university students at Cumhuriyet University of Sivas in Turkey. METHODS: A total of 1601 university students participated in this study and answered the questionnaires. The study was conducted in three stages: the self-questionnaire, the neurological evaluation, and the psychiatric evaluation. In the first stage, the subjects completed a questionnaire to assess migraine symptoms. In the second stage, the subjects who reported having migraines underwent a detailed neurological evaluation conducted by a neurologist to confirm the diagnosis. In the final stage, the subjects with migraines completed a psychiatric examination using the structured clinical interview for DSM IV-R Axis I. RESULTS: The self-reported migraine prevalence rate was 13.7%, and the actual prevalence rate of migraine among the university students was calculated to be 10.6% (n=169). When the results obtained with the SCID-I were examined, a current SCID-I psychiatric diagnosis was found in 39 (23.1%) of the 169 subjects with migraines. A total of 73 (43.2%) students with migraines had a lifetime SCID-I psychiatric diagnosis. CONCLUSIONS: The results of this study indicate that migraines were highly prevalent among university students in Turkey with comorbid psychiatric disorders. Treatment strategies must be developed to manage these comorbidities.

Atypical antipsychotic use is an independent predictor for the increased mean platelet volume in patients with schizophrenia: A preliminary study.

BACKGROUND: Cardiovascular diseases, cardiovascular risk factors, and mortality due to these situations are more frequently encountered in schizophrenic patients when compared with the general population. The mean platelet volume (MPV) is a surrogate biomarker of the platelet activity and an useful prognostic test in cardiometabolic diseases. The aim of this study was to investigate what influenced MPV levels in patients with schizophrenia. MATERIALS AND METHODS: We evaluated hospital records of 60 hospitalized schizophrenia patients. Thirty age- and sex-matched healthy control subjects were also included as a control group. RESULTS: MPV levels were significantly higher in patients who were on atypical antipsychotic drugs than in patients who were not using any drug (9.2 ± 0.8 vs. 8.6 ± 0.8 fL, P = 0.016) and also higher than control group (9.2 ± 0.8 vs. 8.1 ± 0.9 fL, P < 0.001). Furthermore, patients who were not using antipsychotics had higher MPV than control group (8.6 ± 0.8 vs. 8.1 ± 0.9 fL, P = 0.036). Atypical antipsychotic use [Odds ratio (OR) =6.152, 95% confidence interval (CI,) P = 0.003)] and platelet distribution width (OR = 0.989, 95% CI, P = 0.032) were associated with high MPV levels in univariate analysis. In multivariate logistic regression model, only atypical antipsychotics use (OR = 6.152, 95% CI, P = 0.003) was found to be independent predictor of high MPV levels after adjustment of other potential confounders (age, gender, presence of hypertension, diabetes mellitus, hyperlipidemia, and smoking). CONCLUSION: MPV seems to be influenced not only by schizophrenia itself but also by atypical antipsychotic drugs. It might be concluded that schizophrenic patients are under increased risk for cardiometabolic diseases and risk factors and this risk is higher in patients on atypical antipsychotic treatment.

Post-Traumatic Stress Disorder in Migraine Patients: Migraine, Trauma and Alexithymia.

INTRODUCTION: In recent studies, it has been suggested that there is a relationship between migraine headaches and post-traumatic stress disorder (PTSD). The PTSD has not been diagnosed by a clinician in these studies; the evaluation has been carried out by the screening scales. Besides, it has also been asserted that there was relationship of alexithymia with migraine and other chronic painful disorders. In this study, our aim was to investigate the prevalence of clinically-diagnosed PTSD and alexithymic features among migraine patients. METHODS: Sixty consecutive migraine patients sent from neurology clinic and 60 healthy controls having similar features constituted the sample of this study. SCID-I/CV PTSD module and the Clinician-Administered PTSD Scale (CAPS) was administered to the sample. The subjects also filled in the socio-demographic data form and the Toronto Alexithymia Scale (TAS). The level of pain perceived by the migraine patients was evaluated using a Visual Analog Scale (VAS). RESULT: 17 subjects (28%) in the migraine group and 5 individuals (8.3%) in the control group were diagnosed with PTSD. Hence, PTSD was found to be statistically significantly higher in the migraine group. 25 persons in the migraine group (41.6%) and 12 in the control group (20%) scored above the TAS cutoff score in terms of alexithymic features. Alexithymia was found to be statistically significantly higher in the migraine group). In the migraine group, VAS scores of the ones with PTSD were statistically significantly higher compared to that in ones without PTSD. 94% of the persons diagnosed with PTSD in the migraine group reported that their migraine headaches started after a traumatic experience. In the migraine group, no statistically significant correlation was detected between CAPS and VAS scores in subjects with PTSD. CONCLUSION: In migraine patients, PTSD and alexithymic features have been found higher than in the healthy controls. Further studies are needed to search whether the practices aimed at treating the PTSD and alexithymic features can contribute to the treatment of migraine headaches or not.

Prevalence of attention-deficit/hyperactivity disorder and co-morbid disorders among students of Cumhuriyet University

Background and Objectives: Most of the previous studies investigated prevalence of attention-deficit/hyperactivity disorder (ADHD) among university students with self report measures. Present study investigated actual prevalence of ADHD and comorbid disorders among university students in Cumhuriyet University of Sivas in Turkey. Methods: In the first stage, 980 university students filled in the Adult ADHD Self-Report Scale and socio-demographic form, 79 of whom were above the cut-off score of Adult ADHD Self-Report Scale, considered as possible ADHD. They were evaluated in the second stage via structured interview SCID I, SCID II, Adult ADHD Module of MINI Plus. In addition, subjects filled in the self report Adult ADD/ADHD DSM IV-Based Diagnostic Screening and Rating Scale. Results: The self report ADHD prevalence rate was 10.1% and the actual prevalence rate of ADHD among the university students was calculated 6.1%. The prevalence of ADHD was greater among male than female (7.0% vs. 5.5%). Among the male students inattentive subtype was 1.6%, hyperactive-impulsive 0.24%, combined 5.1%. Female students were found to be inattentive by 1.45%, hyperactive-impulsive by 0.56% and combined type by 3.48%. Most of the students with ADHD had Axis I (especially depressive disorders) and Axis II disorders (especially cluster B personality disorders). ADHD diagnosis was associated with more cigarette and alcohol use, academic failure, legal problems, somatic complaints and suicide attempts. Students with ADHD were spending more time on the Internet than students without ADHD. Only one student diagnosed with ADHD reported to have had previous ADHD diagnosis. Conclusions: ADHD is common among university students. Having a diagnosis of ADHD in early adulthood seems to be associated with psychological, social, and academic problems (AU)

Migraine prevalence, alexithymia, and post-traumatic stress disorder among medical students in Turkey.

The aim of this study was to investigate the prevalence of migraine, alexithymia, and post-traumatic stress disorder among medical students at Cumhuriyet University of Sivas in Turkey. A total of 250 medical students participated in this study and answered the questionnaires. The study was conducted in three stages: the self-questionnaire, the neurological evaluation, and the psychiatric evaluation. In the first stage, the subjects completed a questionnaire to assess migraine symptoms and completed the three-item Identification of Migraine Questionnaire, the Toronto Alexithymia Scale, and the Post-Traumatic Stress Disorder Checklist-Civilian Version Scale. The subjects who reported having a migraine underwent a detailed neurological evaluation conducted by a neurologist to confirm the diagnosis. In the final stage, the subjects with a migraine completed a psychiatric examination using the structured clinical interview for DSM-IV-R Axis I. The actual prevalence of migraine among these medical students was 12.6 %. The students with a migraine were diagnosed with alexithymia and post-traumatic stress disorder more frequently than those without migraine. The Migraine Disability Assessment Scale scores correlated with the post-traumatic stress disorder scores. The results of this study indicate that migraine was highly prevalent among medical students in Turkey and was associated with the alexithymic personality trait and comorbid psychiatric disorders including post-traumatic stress disorder. Treatment strategies must be developed to manage these comorbidities.

Sleep quality and immune functions in rheumatoid arthritis patients with and without major depression.

The purpose of this study was to determine the discriminative factors between rheumatoid arthritis (RA) patients with and without major depression (MD). We assessed subjective sleep quality, pain, and cell-mediated immune functions in RA patients with (n = 20) and without (n = 20) MD by using Pittsburgh Sleep Quality Index (PSQI), visual analogue scale (VAS), and fluorescein isothiocyanat (FITC) labeled CD3, CD4, CD8, CDI9, CD45, CD56, and HLADR T monoclonal antibodies by flow cytometry. We found that the RA patients with MD had significantly higher pain level, poorer sleep equality, higher HDRS points, and higher HLADR T cell level than those without MD; and that these variables are discriminant factors between patient groups. These findings suggest that the RA patients with MD may be differentiated from those without MD by using VAS, PSQI, and HLADR levels; that these variables correctly classify the depressed and non depressed groups up to an accuracy level of 96.8%.