Browsing by Author "Kirli, Umut"

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Comparison of the Risk of Drop-Out From Opioid Maintenance Treatment in Patients Using Naltrexone Implants Vs. Oral Buprenorphine-Naloxone
(Klinik Psikiyatri dergisi, 2021) Kirli, Umut; Nart, Omer
Objective: Through increasing prevalence, opioid use disorder has been an important public health problem. The aim of this study is to compare the risk of drop-out from opioid use disorder maintenance treatment in patients using naltrexone implants vs. oral buprenorphine-naloxone, and to assess some sociodemographic and clinical correlates of drop-out. Method: The study has a retrospective-cohort design. All patients who completed the 21-days inpatient detoxification treatment between January 1st - November 1st, 2019 in a specialized alcohol and substance abuse treatment centre, and planned to be treated with either oral buprenorphine-naloxone or naltrexone implants were included in the study (n: 107). The associations between the drop-outs from the maintenance treatment and the treatment used (buprenorphine-naloxone or naltrexone implants), sociodemographic/clinical characteristics were assessed via multivariate cox regression. Results: No large or significant differences in sociodemographic and clinical characteristics were found between the two treatment groups. Both univariate and multivariate analysis showed no significant differences in the risk of drop-out from treatment between patients using oral buprenorphine-naloxone vs. naltrexone implants (Hazard Ratio: 1.39, %95CI: 0.82-2.35, p: 0.2). Multivariate analysis showed that presence of another substance use in addition to opioid use was significantly associated with the risk of drop-out (Hazard Ratio: 1,79, %95CI: 1,06-3,16, p: 0,04). Discussion: Results suggest no significant difference in the risk of drop-out from opioid maintenance treatment in patients using naltrexone implants vs. oral buprenorphine-naloxone. Additional substance use should be carefully considered while planning opioid use disorder maintenance treatment.
Covid 19 Pandemic and Psychotic Symptoms
(Klinik Psikiyatri dergisi, 2020) Kirli, Umut; Binbay, Tolga; Elbi, Hayriye; Alptekin, Koksal
COVID-19 pandemic causes substantial psychosocial stress on individuals and the community. Due to social isolation, neurotrophic potential of coronaviruses and the inflammatory processes, occurrence and relapse of psychotic symptoms may increase during the pandemic. Furthermore, pandemic has limited some protective factors for psychosis (i.e. social support, community mental health practices and physical activity). Additionally, admission of individuals suffering from psychotic symptoms may decrease due to risk of viral contamination. This may lead to under-detection of the problem, persistence of psychotic symptoms, poorer prognosis and more severe outcomes. Psychotic symptoms were reported among infected individuals during the recent coronavirus outbreaks (SARS CoV-1 and MERS CoV). Furthermore, mental problems were of the most substantial causes of long term disability associated with these outbreaks. In this paper, limited data on psychotic symptoms during the COVID-19 pandemic will be reviewed. Furthermore, psychosocial stress during the pandemic and plausible associations between the coronaviruses and psychotic symptoms will be discussed in light of the previous research.
An Innovative Approach To Lifelong Delayed Ejaculation: Does Attachment Style Play a Role
(Springer, 2022) Demir, Murat; Isik, Mesut; Araz, Seyhmuz; Ozveren, Huseyin; Kirli, Umut; Ertas, Kasim
Purpose To examine whether there is a correlation between attachment styles, which is a developmental psychology theory, and lifelong DE. Methods The research was planned as prospective, multi-centric and cross-sectional study. Thirty patients who were consecutively admitted to the urology outpatient clinic and diagnosed with lifelong DE and 30 age-matched healthy controls were included in the study. All participants gave a detailed medical history and underwent a complete physical examination, and their laboratory and endocrine (prolactin and testosterone) results were evaluated. Additionally, all patients had to fill out socio-demographic information form, the Experiences in Close Relationships-Revised (ECR-R) Questionnaire, Arizona Sexual Experiences Scale (ASEX), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). Results The mean age of the DE patients was 33.5 +/- 7.5 years. In the DE group, insecure attachment (both anxious and avoidant attachment), anxiety and depression scores were found to be significantly higher (p < 0.001, effect size medium or large) than the control group. Ejaculation times (both for vaginal intercourse and masturbation) were correlated with both insecure (anxious and avoidant) attachment types, as well as their anxiety and depression scores (p < 0.001). The ASEX satisfaction, ejaculation and total scores were found to be higher in DE patients (higher scores indicating greater sexual dysfunction) than in the control group. Conclusion The large and significant relationships found between lifelong DE and attachment insecurities point to childhood developmental processes. The findings may help us better understand lifelong DE. There is a need for further extensive research on this subject.
Izmir Mental Health Cohort for Gene-Environment Interaction in Psychosis (Turksch): Assessment of the Extended and Transdiagnostic Psychosis Phenotype and Analysis of Attrition in a 6-Year Follow-Up of a Community-Based Sample
(Frontiers Media Sa, 2019) Kirli, Umut; Binbay, Tolga; Elbi, Hayriye; Drukker, Marjan; Kayahan, Bulent; Ozkinay, Ferda; van Os, Jim
Objective: TurkSch is a prospective, longitudinal study in a representative community sample (Izmir, Turkey), consisting of several data collection stages, to screen and follow-up mental health outcomes, with a special focus on the extended and transdiagnostic psychosis phenotype. The aim of the present paper is to describe the research methodology, data collection results, and associations with noncontact and refusal in the longitudinal arm. Methods: Households were contacted in a multistage clustered probability sampling frame, covering 11 districts and 302 neighborhoods at baseline (n = 4,011) and at 6-year follow-up (n = 2,185). Both at baseline and at follow-up, participants were interviewed with the Composite International Diagnostic Interview. Participants with probable psychotic disorder were reinterviewed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID)-I either at the hospital or at the participant's residence. Relevant neighborhood-level measures were assessed in a separate sample (n = 5,124) in addition to individual-level measures. Candidate gene-by-environment interactions were investigated using two nested case-control studies. Results: Individuals with a mental health problem had lower refusal rates. Older and lower educated individuals had a lower probability of noncontact. Discussion: The TurkSch study has an advanced design to meet the challenges of evaluating the multidimensional etiological and phenomenological nature of the extended and transdiagnostic psychosis phenotype.
The Mediating Effect of Attachment Insecurity on Circadian Consequences of Childhood Trauma
(Taylor & Francis inc, 2022) Isik, Mesut; Kirli, Umut
Circadian preferences have been associated with mental health as well as social and physical health in recent years. However, factors associated with circadian preferences have not been fully elucidated. The main aim of this study is to investigate the associations of childhood trauma and attachment styles with circadian preferences. A total of 673 participants were evaluated using the Morningness-Eveningness Questionnaire (MEQ), the Childhood Trauma Questionnaire 28 (CTQ-28), and the Experiences in Close Relationships-Revised (ECR-R) questionnaire. The results indicated that 14.9% (n = 100) of the participants were morning type, 20.6% (n = 139) were evening type, and 64.5% (n = 434) were intermediate type. Both childhood trauma and attachment-related anxiety/avoidance scores were associated with being evening type (p < .01). Moreover, attachment-related anxiety and avoidance fully mediated the association between childhood trauma and circadian preferences. The present study showed that attachment styles might be associated with circadian preferences. Further studies are needed to replicate these results and to infer explanatory mechanisms for these cross-sectional associations.
The Mental Health of Healthcare Professionals During the Covid-19 Pandemic
(Turkiye Sinir ve Ruh Sagligi dernegi, 2021) Isik, Mesut; Kirli, Umut; Ozdemir, Pinar Guzel
Objective: The aim of this study is to investigate the anxiety, depression, insomnia and post traumatic stress disorder (PTSD) symptoms and the assocaited sociodemographic, clinical and professional factors during the COVID-19 pandemic in healthhcare workers. Method: A total of 509 participants joined an online survey to complete the data acquisition tools consisting of a Sociodemographic and Clinical Questionnaire, the Hospital Anxiety and Depression Scale (HADS), the Insomnia Severity Index (ISI) and the Post Traumatic Stress Disorder-Short Scale (PTSD-SS). Results: The 509 participants of the study consisted of physicians (69.2%) and nurses (30.8%). On the basis of the scores above the cut-off points of the pscyhometric scales used, the mental symptoms of the participants were ranked as 54.2% on depression, 26.3% on anxiety, 20.8% on insomnia and 8.8% on PTSD. The corresponding scores of the 20-30 year old, the female and the nursing participants were significantly higher as compared to the others (p<0.001, for all). Significant differences were not found in these scores with respect to working or not working directly with COVID-19 patients, or having a family member with or without COVID-19 infection (p>0.05). Having a history of suspected COVID-19 infection was significantly associated with insomnia (p=0.026 and PTSD (p=0.008). Also, the anxiety and PTSD scores of the participants with a history of mental disorder diagnosis were significantly higher in comparison to the others (p<0.001). Conclusion: The results indicated that females, nurses, participants in the 20-30 year age group and with a history of mental disorder diagnosis were in the high risk group for impaired mental health, irrespective of their professional positions. Close monitoring and early intervention are essential for these high-risk individuals.
The Role of Thought Suppression in Conversion Disorder in Relation To Depression, Symptom Interpretation and Sleep Hygiene: a Case-Control Study
(Univ Sao Paulo, inst Psiquiatria, 2020) Ozdemir, Pinar Guzel; Kirli, Umut; Isik, Mesut; Tapan, Suheda
Background: Thought suppression has been associated with a number of psychiatric disorders. However, the association with conversion disorder (CD) has not been investigated yet. Objective: To investigate the role of thought suppression in CD. Methods: Eighty consecutive outpatients with a diagnosis of CD and sixty age, sex and neighborhood-similar controls were evaluated using Beck Depression Inventory-I (BDI-I), White Bear Suppression Inventory (WBSI), Symptom Interpretation Questionnaire (SIQ) and Sleep Hygiene Index (SHI). Cases and controls were compared in regard to thought suppression scores considering their status of high depression scores via a logistic regression model. The reciprocal associations of thought suppression with other clinical dimensions in CD were assessed. Finally, structural equation modelling was applied to untangle the possible connections. Results: CD patients had significantly higher scores of thought suppression than the control group. However, the difference was below the significance level when CD patients without comorbid high depression scores were taken into account. Thought suppression was associated with the clinical severity of CD. According to the structural equation model, older age and somatic attributions to the common bodily sensations were the significant correlates of thought suppression among CD patients. Discussion: Thought suppression may be considered as a non-specific marker of clinical severity in CD.