Browsing by Author "Saǧlam, M."

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A Case With Late-Onset Obsessions and Compulsions Following Chronic Cerebral Ischemia
(2004) Beşiroǧlu, L.; Özer, Ö.A.; Bal, A.C.; Saǧlam, M.
Obsessive-compulsive disorder (OCD) is an illness that usually manifests itself in the second or third decade of the life. Onset of OCD after age 70 has been rarely reported in the literature. Late-onset OCD is generally associated with an underlying cerebrovascular disease. The current consensus regarding choice of treatment(s) for idiopathic OCD includes cognitive behavioral therapy and serotonin reuptake inhibitors. However, the effectiveness of cognitive behavioral therapy or medications in cases with obsessive-compulsive symptoms due to general medical conditions has remained unclear. In this paper, an elderly patient who had late-onset obsessions and compulsions following chronic cerebral ischemia is presented with special emphasize made on specific issues about late-onset OCD cases and the application of standard therapeutic methods to these patients.
Factors Associated With Quality of Life in Obsessive Compulsive Disorder
(Cukurova University, Faculty of Medicine, 2007) Beşiroǧlu, L.; Uǧuz, F.; Saǧlam, M.; Yilmaz, E.; Aǧargün, M.Y.; Aşkin, R.
Objective: Since obsessive compulsive disorder (OCD) is an illness that considerably influences the family, academic, occupational and social functioning of patients, the relationship between OCD and QOL has been acquiring more importance. The present study was designed to investigate which aspects of quality of life (QOL) are most affected in OCD and to explore the predictors of decreased QOL in OCD. Methods: Seventy three patients with OCD and 69 healthy control subjects were compared in terms of their quality of life scores by means of WHOQOL-BRIEF. The relationship between QOL and probable clinical variables were explored by means of multivariate regression analyses. Results: Psychological health and social relationship scores of OCD patients were significantly lower than healthy subjects. Multivariate regression analyses revealed that the severity of depressive symptoms was the best predictor of both psychical health, and psychological health. The presence of comorbid personality disorder was the second significant factor to predict psychological health. While the severity of compulsions was the sole associated factor with psychological health, in second model, severity of depression as an associated variable was added to equation. Only the duration of illness was associated with environment scores. In the bivariate correlational analyses, while the severity of obsessions and depressive symptoms were significantly associated with psychological health, there is no association between psychological health and compulsion severity. Discussion: Since the subjective perception of QOL is considerably affected by depression severity, a quality of life assessment instrument that is specific for OCD should be developed.
Psychopharmacological Treatment Response in Obsessive Compulsive Patients With Autogenous and Reactive Obsessions
(2007) Beşiroǧlu, L.; Uǧuz, F.; Saǧlam, M.; Aǧargün, M.Y.; Aşkin, R.; Çilli, A.S.
Objective: It has been suggested that obsessions related with different cognitive process can be discriminated as autogenous and reactive obsessions. This study aimed to compare treatment response to psychopharmacological interventions of the OCD patients with autogenous and reactive obsessions. Methods: Using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Hamilton Depression Rating Scale (HDRS) and White Bear Suppression Inventory we assessed 20 patients with auotogenous obsessions (Autogenous group, AG) and 22 patients with reactive obsessions (Reactive group, RG) who met the DSM-IV criteria for OCD. The patients were consecutively assigned to receive either sertraline (100-200 mg/day), fluvoxamine (200-300 mg/day) or paroxetine (40-80 mg/day). We reassessed 80% of the initial AG (n=16) and 68% of initial RG (n=15) after 12 weeks. Results: The YBOCS obsession, compulsion, total scores, HDRS and WBSI scores at follow-up in both AG and RG were significantly lower than at baseline scores. The mean differences from baseline to follow up for obsession severity and suppression tendency in the AG were significantly higher than RG. The relationships between mean differences from baseline to follow up assessments on severity of obsessions, depressive symptoms and suppression tendency were found to be significant in the AG. Mean difference from baseline to follow up assessments on severity of obsessions were significantly associated with mean difference for compulsion severity in the RG. Conclusions: Discrimination for obsessions based on autogenous versus reactive may have implications for identifying psychopathological mechanisms implicated in the OCD, and for understanding variability in treatment response.