Browsing by Author "Besiroglu, Lutfullah"

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Alterations in P Wave Duration and Dispersion in Depressive Patients Following Electroconvulsive Therapy
(Elsevier Science inc, 2012) Aydin, Adem; Gumrukcuoglu, Hasan Ali; Selvi, Yavuz; Besiroglu, Lutfullah; Ozdemir, Pinar G.; Ozdemir, Osman; Cegin, Bilal
Objective: Electroconvulsive therapy (ECT) consists of controlled convulsive seizure by electric stimulation of the brain. Although various electrocardiographic (ECG) changes have been reported during ECT, atrial conduction has not been studied extensively. The aim of the present study was to assess the effects of ECT on systemic arterial blood pressure and ECG parameters (P wave duration, P wave dispersion and heart rate). Methods: Thirty depressive patients undergoing ECT were included. Echocardiographic examination was performed on all patients before ECT sessions to exclude systolic heart failure and diastolic dysfunction which may affect P wave duration and dispersion. Twelve-lead ECG records were obtained before the first ECT and after the third session of ECT. Blood pressure was measured before and after convulsive therapy session. Results: Compared to baseline values, maximum P wave duration (99.3 +/- 14.6 to 111.3 +/- 8.2 ms, P=.001), P wave dispersion (50 +/- 14.8 to 63.3 +/- 10.3 ms, P=.001), and systolic (110.7 +/- 12 to 116 +/- 12.2 mmHg, P=.043) and diastolic blood pressures (70.7 +/- 9.4 to 75.3 +/- 8.2 mmHg, P=.028) were significantly increased after convulsive therapy session. Conclusions: We proposed that ECT alone or in combination with atypical antipsychotics or antidepressants may influence atrial conduction as evidenced by the significantly prolonged maximum P wave duration and P wave dispersion. Longer-term follow-up of patients undergoing ECT may be appropriate to evaluate the possible long-term outcomes of our short-term results. (C) 2012 Elsevier Inc. All rights reserved.
Associations Between Chronotype, Sleep Quality, Suicidality, and Depressive Symptoms in Patients With Major Depression and Healthy Controls
(Taylor & Francis inc, 2010) Selvi, Yavuz; Aydin, Adem; Boysan, Murat; Atli, Abdullah; Agargun, Mehmed Yucel; Besiroglu, Lutfullah
Research interest concerning associations between sleep characteristics and suicidality in psychopathology has been growing. However, possible linkages of suicidality to sleep characteristics in terms of sleep quality and chronotypes among depressive patients have not been well documented. In the current study, the authors investigated the possible effects of sleep quality and chronotype on the severity of depressive symptoms and suicide risk in patients with depressive disorder and healthy controls. The study was conducted on 80 patients clinically diagnosed with major depression and 80 healthy subjects who were demographically matched with the patient group. All participants completed a questionnaire package containing self-report measures, including the Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), Morningness-Eveningness Questionnaire (MEQ), and Suicide Ideation Scale (SIS), and subjects were interviewed with the suicidality section of the Mini-International Neuropsychiatric Interview (MINI). Results are as follows: (a) logistic regression analyses revealed that poor sleep quality and depression symptom severity significantly predicted onset of major depression; (b) morningness-type circadian rhythm may play as a significant relief factor after onset of major depression; (c) sleep variables of chronotype and sleep quality did not significantly predict suicide ideation after controlling for depressive symptoms in the major depression group; and (d) suicide ideation and poor sleep quality were antecedents of depression symptom severity in patients with major depression, and in healthy controls. Findings are discussed under the theoretical assumptions concerning possible relations between chronotype, sleep quality, depression, and suicidality. (Author correspondence: dryavuzselvi@yahoo.com).
Atypical Psychiatric Symptoms Associated With Left Temporal Lesion: Two Cases
(Kure Iletisim Grubu A S, 2010) Selvi, Yavuz; Aydin, Adem; Besiroglu, Lutfullah
Brain lesion is a major risk factor for the development of psychiatric symptoms. There is an association between lesion type, location, and psychiatric symptoms. Common psychiatric comorbidities of brain lesions include affective, cognitive, and behavioral disorders; therefore, organic causes should be carefully investigated by clinicians and treatment regimens planned by considering organic causes. In this report, two patients with left temporal lesions, who developed atypical psychiatric symptoms, are described and the distinctive features of their diagnoses are summarized.
Catatonic Symptoms Associated With Tuberculous Lymphadenitis: a Case of Catatonia
(Turkish Neuropsychiatry Assoc-turk Noropsikiyatri dernegi, 2011) Selvi, Yavuz; Ozdemir, Pinar Guzel; Atli, Abdullah; Besiroglu, Lutfullah
Catatonia is a neuropsychiatric syndrome that can occur due to medical or psychiatric disorder. Catatonia with a medical co-morbidity accounts for 30-80% of all catatonias. These conditions are various and include infections, metabolic disturbances, neurological disorders, drug intoxication and withdrawal. Identifying causes for catatonia is important not only to guide proper management but to determine prognostic outcomes. Tuberculous lymphadenitis is part of the extrapulmonary tuberculosis and is the most common form of the mycobacterial lymphadenitis group. Tuberculous lymphadenitis-induced catatonia has not been reported yet in the literature. We report the case of a patient who presented with catatonia and showed partial improvement with electroconvulsive therapy and complete recovery after treatment with anti-infective drugs. (Archives of Neuropsychiatry 2011; 48: 265-7)
Cerebellar Cognitive Affective Syndrome: a Case Report
(Kure Iletisim Grubu A S, 2008) Besiroglu, Lutfullah; Gulec, Mustafa; Kiran, Songul Gundogdu; Polat, Nermin
Although the role of the cerebellum on motor control has been well recognized in studies of functional neuroanatomy, the influence of the cerebellum on cognition and emotion has been neglected until recent years. In the last decades studies that have described the role of the cerebellum on cognitive functions and emotion have been published. In patients with impaired executive dysfunction and visuo-spatial cognition, personality changes, affective symptoms and linguistic difficulties due to different cerebellar lesions, this clinical entity was described as Cerebellar Cognitive Affective Syndrome. In this paper, we present a case with Cerebellar Cognitive Affective Syndrome, and with neuroradiological evidence of a chronic cerebellar lesion.
Childhood Traumatic Experiences, Dissociation and Thought Suppression in Patients With 'psychosomatic Skin Diseases
(Wiley, 2009) Besiroglu, Lutfullah; Akdeniz, Necmettin; Agargun, Mehmet Yucel; Calka, Omer; Ozdemir, Osman; Bilgili, Serap Genes
In this study, patients with what were considered 'psychosomatic' skin diseases were compared with patients with skin conditions that are thought to be 'non-psychosomatic' diseases in terms of their reported history of childhood traumatic experiences, dissociative experiences and thought suppression. Ninety-six patients with 'psychosomatic' skin disease were included in the study. The comparison subjects (n = 54) were patients with skin conditions believed to have a negligible psychosomatic component and the subjects without skin disease (n = 77). Subjects were administered with the Childhood Trauma Questionnaire (CTQ), the Dissociative Experiences Scale (DES) and the White Bear Suppression Inventory (WBSI). While the 'emotional neglect' scores of the psychosomatic' group were significantly higher than that of both 'non-psychosomatic' and healthy subjects, there were no significant differences for the other subscales of the CTQ. The 'psychosomatic' group scored significantly higher on the DES absorption scale, DES total and WBSI scores than the other groups. Significantly more patients in the 'psychosomatic' group reported a stressful life event as related to the onset of skin complaints compared with the 'non-psychosomatic' group. Our results suggest that the effect of subjective perception of emotional neglect, mediated by stressful life events, increases the vulnerability to psychosomatic disease. Copyright (C) 2008 John Wiley & Sons, Ltd.
Chronotype Differences in Suicidal Behavior and Impulsivity Among Suicide Attempters
(Taylor & Francis inc, 2011) Selvi, Yavuz; Aydin, Adem; Atli, Abdullah; Boysan, Murat; Selvi, Fatih; Besiroglu, Lutfullah
Morning- and evening-type individuals differ on a number of psychological and biological variables. There has been increasing interest in the relationship between chronotype and personality traits. The aim of this study was to investigate the relationship between impulsivity and chronotype in suicide attempters. Eighty-nine suicide attempters were included in the study, and systematic information on suicide attempts was recorded. The Morningness-Eveningness Questionnaire was applied to determine chronotype, and attempter impulsivity was measured by the total score of the Barratt Impulsiveness Scale. Significant differences between chronotype and impulsivity scores were found. Evening-type subjects reported significantly higher impulsivity scores than both neither- and morning-types. A significant association between chronotype and type of suicide attempt was detected. The largest proportion of violent suicide attempters were evening-type subjects. Violent suicide attempters also reported significantly higher impulsivity scores than nonviolent attempters. Previous studies have pointed out possible relations between eveningness and impulsivity. Current findings suggest that eveningness may be a risk factor for violent suicide attempts by increasing impulsivity. (Author correspondence: dryavuzselvi@yahoo.com).
Chronotypes and Oxidative Stress: Is There an Association
(Taylor & Francis Ltd, 2012) Selvi, Yavuz; Ozkol, Halil; Tuluce, Yasin; Besiroglu, Lutfullah; Ozdemir, Pinar Guzel
Human studies suggest that free radicals and antioxidant enzymes can alter according to age, lifestyle, environment, and habits. Individuals having a marked circadian preference, that is, morning type or evening type, differ on a number of psychological, behavioral, and biological variables. The aim of this study was to determine whether chronotype impacts some parameters of oxidant and antioxidant status. For this purpose, glutathione peroxidase (GSH-P-x), superoxide dismutase (SOD), and myeloperoxidase (MPO) activities and the levels of reduced glutathione (GSH) and malondialdehyde (MDA) were measured in 96 healthy volunteers (including 32 morning-type, 32 intermediate-type, and 32 evening-type individuals), aged between 21 and 26 years. There were no significant relationships between the chronotypes with regard to oxidant and antioxidant parameters. Our results indicated that the levels of GSH and MDA as well as the activities of GSH-P-x, MPO, and SOD were not influenced by the individual circadian differences in our sample. These results were discussed using the theoretical concepts of age-related factors, and suggestions for further research presented.
The Comparison of Aripiprazole and Risperidone Augmentation in Selective Serotonin Reuptake Inhibitor-Refractory Obsessive-Compulsive Disorder: a Single-Blind, Randomised Study
(Wiley, 2011) Selvi, Yavuz; Atli, Abdullah; Aydin, Adem; Besiroglu, Lutfullah; Ozdemir, Pinar; Ozdemir, Osman
Objective To investigate the comparative efficacy of aripiprazole and risperidone as augmenting agents in the treatment of obsessive-compulsive disorder (OCD) patients who did not show a >= 35% decrease in the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) after 12-week monotherapy with selective serotonin reuptake inhibitors (SSRIs). Methods The study consists of two different periods of treatment: a 12-week prospective period to determine resistance to SSRI treatment and an 8-week single-blind addition period for refractory patients only. Ninety patients were randomly assigned to receive one of the SSRI treatments. Sixty-nine patients (76.6%) completed the 12-week SSRI monotherapy period. Forty-one patients (59.4%) were considered refractory and were randomised to receive either risperidone (20 patients, 3 mgr daily) or aripiprazole (21 patients, 15 mgr daily) as augmentation to SSRI treatment. Sixteen patients (76.2%) in the aripiprazole group and 18 patients (84%) in the risperidone group completed the 8-week treatment period. Results Eight patients (50%) in aripiprazole and 13 patients (72.2%) in risperidone group met response criteria of Y-BOCS decrease >= 35% at the end of the study. The risperidone group showed a significant improvement in Y-BOCS obsession scores compared with aripiprazole. Conclusions The present findings suggest that risperidone may be more effective than aripiprazole. Copyright (C) 2011 John Wiley & Sons, Ltd.
Comparison of Dream Anxiety and Subjective Sleep Quality Between Chronotypes
(Springer Japan Kk, 2012) Selvi, Yavuz; Aydin, Adem; Gulec, Mustafa; Boysan, Murat; Besiroglu, Lutfullah; Ozdemir, Pinar Guzel; Kilic, Sultan
Morning and evening-type individuals differ on a number of psychological and biological variables. In this study, we aimed to investigate the relationship between sleep quality, dream anxiety, and chronotypes. A sample of 264 university students, aged between 17 and 26 years, completed the MorningnessEveningness Questionnaire, the Pittsburgh Sleep Quality Index, and the Van Dream Anxiety Scale for assessing nightmare frequency and the dream anxiety caused by frightening dreams. Main findings indicated that evening-type individuals were significantly more likely to suffer from poor sleep quality, daytime dysfunction, nightmares, and nightmare-related disturbances as compared to either intermediate- or morning-type individuals. Previous studies have pointed out the possible connections of irregular sleepwake habits and circadian dysregulation with a tendency to reveal eveningness chronotypical characteristics. Current findings suggest that evening-type individuals are more prone to experience psychologically deteriorating nightmares and sleep-related anxiety. Poor sleep quality is also a significant antecedent of dream anxiety after controlling for age and gender.
Comparison of Superoxide Dismutase, Glutathione Peroxidase and Adenosine Deaminase Activities Between Respiratory and Nocturnal Subtypes of Patients With Panic Disorder
(Karger, 2012) Ozdemir, Osman; Selvi, Yavuz; Ozkol, Halil; Tuluce, Yasin; Besiroglu, Lutfullah; Aydin, Adem
Objective: There is mounting evidence indicating that oxidative and inflammatory processes may have an important role in the pathogenesis of panic disorder (PD). PD is a heterogeneous disease, and panic attacks are divided according to the different symptom clusters as respiratory, nocturnal, non-fearful, cognitive, or vestibular subtypes. The aim of this study was to compare whole-blood and serum superoxide dismutase (SOD), glutathione peroxidase and adenosine deaminase activities in PD patients with/without nocturnal, respiratory subtypes and healthy subjects. Methods: The study was conducted including 60 patients with PD and 30 healthy control subjects. The Panic Attack Symptom Checklist, Panic and Agoraphobia Scale, Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale were administered to the patients. Biochemical analyses were performed after all the blood samples were collected. Results: We found that whole-blood SOD and glutathione peroxidase activities of patients were significantly lower and adenosine deaminase activities of patients were higher than those of healthy controls. There were no statistically significant differences between respiratory and nocturnal subtypes. In addition, there were no marked relationships between the duration of illness and panic-agoraphobia scores of patients with nocturnal subtypes. Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale scores of patients with the nocturnal subtype were markedly higher than those of patients without the nocturnal subtype. Conclusion: The results suggest that oxidative and inflammatory processes may play a role in the pathophysiology of PD. These findings may support the idea that both nocturnal and respiratory subtypes of PD have different symptom clusters of the same disease. Copyright (C) 2012 S. Karger AG, Basel
Comparison of Treatment Responses and Clinical Characteristics of Early-Onset and Late-Onset Obsessive-Compulsive Disorder
(informa Healthcare, 2006) Uguz, Faruk; Askin, Rustem; Cilli, Ali S.; Besiroglu, Lutfullah
Objective. The clinical characteristics and response to pharmacotherapy of adult patients with early-onset and late-onset obsessive-compulsive disorder (OCD) were compared in this study. Methods. A total of 50 outpatients with OCD diagnosed according to DSM-IV criteria (early-onset: 20; late-onset: 30) were included in the study. After initial clinical evaluation with The Structured Clinical Interview for DSM-IV/Clinical Version (SCID-I/CV), The Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) and Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), all patients were treated with fluvoxamine, sertraline or paroxetine for 12 weeks. Treatment response was defined as a >= 35% reduction in the Y-BOCS-total scores from baseline in a 12-week follow-up period. Results. Forty-three patients (early-onset: 16; late-onset: 27) completed the study. The early-onset group had higher frequencies of symmetry/exactness obsessions and ordering/arranging compulsions, and the late-onset group had higher mean age at assessment. Nine (56.3%) patients with early-onset and 18 (66.7%) with late-onset responded to pharmacotherapy. The difference between response rates was not statistically significant. Conclusions. Our study suggests that although there are some phenomenological differences between patients with early-onset OCD and late-onset OCD, these patients have similar responses to pharmacotherapy.
The Correlates of Healthcare Seeking Behavior in Obsessive-Compulsive Disorder
(Turkiye Sinir ve Ruh Sagligi dernegi, 2006) Besiroglu, Lutfullah; Agargun, Mehmet Yucel
Obsessive-compulsive disorder (OCD) is a chronic, distressing, and disabling illness that influences the family, academic, occupational, and social functioning of patients. One of the 10 leading causes of disability worldwide is OCD; however, despite the considerable distress and disability associated with the disorder and the availability of treatment options, many OCD sufferers usually are not inclined to seek healthcare. The factors that may be central to healthcare seek behavior in OCD has scarcely been described in the literature. It has been thought that the best predictor of healthcare seeking is severity of illness; however, individuals with OCD may have various barriers to seeking healthcare. Although non-disease and disease-related factors that may influence health care seeking are related in complex ways through reciprocal influences and feedback, each factor might be an independent predictor of use of healthcare services. This review aims to discuss the impact of the disease and general factors that impact healthcare seeking behavior in OCD. In this way, new information might be provided for the identification of targets to enhance the use of mental health services among OCD sufferers in the community.
Development and Preliminary Psychometric Properties of an Instrument for the Measurement of Obsessional Dissociative Experiences: the Van Obsessional Dissociation Questionnaire (vod-Q)
(Springer, 2018) Boysan, Murat; Yildirim, Abdullah; Besiroglu, Lutfullah; Kefeli, Mehmet Celal; Kagan, Mucahit
A growing body of research evidence documents the substantial associations between obsessive-compulsive disorder (OCD) and dissociation. This article describes the development and preliminary psychometric properties of the Van Obsessional Dissociation Questionnaire (VOD-Q). Obsessional dissociation is defined as a tendency to dissociate in reaction to distressing, unwanted and intrusive thoughts, images and impulses. The screening tool is conceptualized to tap obsessional dissociation across three dimensions: obsessional absorption, obsessional depersonalization/ derealization and obsessional amnesia. The VOD-Q, the Padua Inventory-Revised (PI-R), the Dissociative Experiences Scale (DES), and the Obsessive Belief Questionnaire (OBQ-44) were administered in this study. The results showed that the VOD-Q had excellent test-retest reliability (ranging from 0.73 to 0.90) and internal consistency (ranging from 0.90 to 0.97). The VOD-Q total and subscale scores were significantly associated with measures of obsessive-compulsive symptoms and dissociative experiences. OCD patients scored significantly higher on the VOD-Q than community participants. Based on the present findings, the VOD-Q appears to be a reliable and valid instrument for the measurement of obsessional dissociative experiences.
Development of a Psychometric Instrument Based on the Inference-Based Approach To Obsessive-Compulsive Disorder: the Obsessional Probabilistic Inference Scale
(Turkish Neuropsychiatry Assoc-turk Noropsikiyatri dernegi, 2014) Gulec, Mustafa; Deveci, Erdem; Besiroglu, Lutfullah; Boysan, Murat; Kalafat, Temel; Oral, Elif
Introduction: The current article addresses the validation of the construct of obsessional probabilistic inference in clinical and non-clinical samples. Obsessional probabilistic inference or obsessional doubt refers to a type of inferential process resulting in the belief that a state of affairs "maybe" causes development of a maladaptive cognitive coping style in terms of obsessing. Methods: The latent structure of the Obsessional Probabilistic Inference Scale (OPIS) was evaluated with confirmatory factor analysis. Results: Explanatory and confirmatory factor analyses indicated that a one-factor solution was satisfactory for the instrument, assessing a unidimensional psychological construct. The OPIS was shown to have high internal consistency in all samples, as well as temporal stability, relying on predominantly non-clinical individuals. The scale exhibited high convergent validity and successfully discriminated patients with obsessive-compulsive disorder from both depressive patients and controls. Conclusion: The findings replicated and extended the role of reasoning process in the development and maintenance of obsessive compulsive symptoms. The results are discussed in regard to assumptions of the inference-based approach to obsessive-compulsive disorder.
Effects of Selective Serotonin Reuptake Inhibitors on Thought-Action Fusion, Metacognitions, and Thought Suppression in Obsessive-Compulsive Disorder
(W B Saunders Co-elsevier inc, 2011) Besiroglu, Lutfullah; Cetinkaya, Nuralay; Selvi, Yavuz; Atli, Abdullah
Objective: We aimed to assess whether cognitive processes change over time in patients with obsessive-compulsive disorder (OCD) receiving selective serotonin reuptake inhibitors without cognitive behavioral therapy and to investigate the factors associated with probable cognitive changes. Methods: During the 16 weeks of the study, 55 patients who met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for OCD received open-label treatment with sertraline (100-200 mg/d) or fluoxetine (40-80 mg/d) and were assessed using the Yale-Brown Obsessive-Compulsive Scale, Beck Depression Inventory (BDI), Thought-Action Fusion Scale (TAFS), Metacognitions Questionnaire (MCQ-30), and White Bear Suppression Inventory (WBSI). Results: The Yale-Brown Obsessive-Compulsive Scale (P < .001), BDI (P < .001), TAFS morality (P < .005), MCQ-30 (P < .01), and WBSI (P < .005) scores at follow-up were significantly lower than baseline scores. When we excluded OCD patients with depressive disorder (n = 12), statistical significance in paired comparisons for MCQ and WBSI disappeared. Similarly, when OCD patients with religious obsessions (n = 16) were excluded, paired comparisons for MCQ and TAF morality were not statistically significant. Changes in BDI, TAFS morality, MCQ-30, and WBSI (P < .005) were significantly correlated with changes in severity of obsessions, but not that of compulsions. After controlling for the change in depression severity, significant correlations between changes in obsessive and cognitive scales did not continue to have statistical significance. The BDI changes (P < .05) significantly explained the changes in symptom severity in a linear regression model. Conclusions: Our findings suggest that selective serotonin reuptake inhibitors can change appraisals of obsessive intrusions via their effects on negative emotions. (C) 2011 Elsevier Inc. All rights reserved.
Factors Associated With Major Depressive Disorder Occurring After the Onset of Obsessive-Compulsive Disorder
(Elsevier, 2007) Besiroglu, Lutfullah; Uguz, Fairuk; Saglam, Mursel; Agargun, Mehmet Yucel; Cilli, Ali Savas
Background: We aimed to investigate the correlates of major depressive disorder (MDD) occurring after the onset of obsessive-compulsive disorder (OCD). Methods: Forty-three OCD patients who developed MDD after the onset of OCD (OCD-MDD group) and 67 OCD patients without MDD (non-MDD, NMDD group) were compared with regard to sociodemographic characteristics, clinical history, symptom severity, types of obsessions and compulsions, insight degree, comorbid axis I and axis 11 diagnosis and quality-of-life level. Results: The OCD-MDD group scored significantly higher on measures of obsessions, compulsions and depression severity than did the NMDD. Significantly more aggressive obsessions were identified in the OCD-MDD group than in the NMDD group. The OCD-MDD group was also significantly more likely than the NMDD group to have generalized anxiety disorder (GAD), There was no significant difference in the rate of personality disorders between the groups. The OCD-MDD group reported significantly lower levels of quality of life (QOL) in the domains of physical health, psychological health and social relationships. Depression severity was associated with obsession but not with compulsion severity. In a logistic regression model, obsession severity, presence of GAD and aggressive obsessions emerged as the factors associated with the occurrence of MDD. Limitations: To exclude ineligible patients, we gathered the information about past mood episodes cross-sectionally. Conclusions: These results suggest that psychopathological processes mediated by specific obsessions as well as excessive anxiety and worries may render the neurocircuities more vulnerable to the development of MDD. The occurrence of MDD in OCD cannot sufficiently be explained as a secondary complication to the disability of OCD. (c) 2006 Elsevier B.V. All rights reserved.
The Impact of Obsessive Beliefs on Pharmacological Treatment Response in Patients With Obsessive-Compulsive Disorder
(Taylor & Francis Ltd, 2011) Selvi, Yavuz; Atli, Abdullah; Besiroglu, Lutfullah; Aydin, Adem; Gulec, Mustafa
Objective. The present study examined whether obsessive beliefs change over time in the OCD patients receiving selective serotonin reuptake inhibitors (SSRIs) and the impact of obsessive beliefs in treatment response. Methods. In the first part of a two-stage study comparing the efficacy of antipsychotics as augmenting agent in SSRI-resistant OCD patients, 57 patients were interviewed with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Hamilton Depression Rating Scale (HDRS) and Obsessive Beliefs Questionnaire-44 (OBQ-44) before and after 12-week of SSRI treatment period. Results. All OBQ-44 subscale scores significantly decreased with SSRI treatment. The mean changes in OBQ-44 Importance and Control of Intrusive Thoughts (I/CT) subscale and HDRS total scores of responders were significantly higher than those of SSRI-resistant patients. The baseline OBQ-44 P/C and Y-BOCS obsession subscale scores significantly predicted the treatment resistance in a logistic regression model. Conclusions. The alleviation of negative mood by SSRIs may help the sufferer to disengage from dysfunctional appraisals. Since individuals with highly obsessive beliefs about P/C are more likely to be resistant to SSRI treatment, the treatment of OCD can be made more effective when focusing on altering appraisals about P/C.
The Influence of Shift Work on Cognitive Functions and Oxidative Stress
(Elsevier Ireland Ltd, 2013) Ozdemir, Pinar Guzel; Selvi, Yavuz; Ozkol, Halil; Aydin, Adem; Tuluce, Yasin; Boysan, Murat; Besiroglu, Lutfullah
Shift work influences health, performance, activity, and social relationships, and it causes impairment in cognitive functions. In this study, we investigated the effects of shift work on participants' cognitive functions in terms of memory, attention, and learning, and we measured the effects on oxidative stress. Additionally, we investigated whether there were significant relationships between cognitive functions and whole blood oxidant/antioxidant status of participants. A total of 90 health care workers participated in the study, of whom 45 subjects were night-shift workers. Neuropsychological tests were administered to the participants to assess cognitive function, and blood samples were taken to detect total antioxidant capacity and total oxidant status at 08:00. Differences in anxiety, depression, and chronotype characteristics between shift work groups were not significant. Shift workers achieved significantly lower scores on verbal memory, attention concentration, and the digit span forward sub-scales of the Wechsler Memory Scale-Revised (WMS-R), as well as on the immediate memory and total learning sub-scales of the Auditory Verbal Learning Test (AVLT). Oxidative stress parameters were significantly associated with some types of cognitive function, including attention concentration, recognition, and long-term memory. These findings suggest that night shift work may result in significantly poorer cognitive performance, particularly working memory. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
Longitudinal Assessment of Symptom and Subtype Categories in Obsessive-Compulsive Disorder
(Wiley-liss, 2007) Besiroglu, Lutfullah; Uguz, Faruk; Ozbebit, Ozgur; Guler, Ozkan; Cilli, Ali Savas; Askin, Rustem
Although it has been postulated that symptom subtypes are potential predictors of treatment response, few data exist on the longitudinal course of symptom and subtype categories in obsessive-compulsive disorder (OCD). Putative subtypes of OCD have gradually gained more recognition, but as yet there is no generally accepted subtype discrimination. Subtypes, it has been suggested, could perhaps be discriminated based on autogenous versus reactive obsessions stemming from different cognitive processes. In this study, our aim was to assess whether symptom and subtype categories change over time. Using the Yale-Brown Obsessive Compulsive Symptom Checklist (Y-BOCS-SC), we assessed 109 patients who met DSM-IV criteria for OCD to establish baseline values, then reassessed 91 (83%) of the initial group after 36 +/- 8.2 months. Upon reassessment, we found significant changes from baseline within aggressive, contamination, religious, symmetry and miscellaneous obsessions and within checking, washing, repeating, counting and ordering compulsion categories. Sexual, hoarding, and somatic obsessions, and hoarding and miscellaneous compulsions, did not change significantly. In accordance with the relevant literature, we also assigned patients to one of three subtypes-autogenous, reactive, or mixed groups. Though some changes in subtype categories were found, no subtype shifts (e.g., autogenous to reactive or reactive to autogenous) were observed during the course of the study. Significantly more patients in the autogenous group did not meet OCD criteria at follow-up than did patients in the other groups. Our results suggest that the discrimination between these two types of obsession might be highly valid, because autogenous and reactive obsessions are quite different, both in the development and maintenance of their cognitive mechanisms, and in their outcome.