Browsing by Author "Selvi, Yavuz"

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Aile İçi Cinsel İstismar Sonrası Zedelenmiş Cinsellik: Kompulsif Cinsel Davranışları Olan Bir Olgu Sunumu
(2011) Atli, Abdullah; Selvi, Yavuz; Özdemir, Pınar Güzel; Kıran, Gündoğdu Songül
Aile içi cinsel istismar, sebep olduğu utanç ve suçluluk duygularının yanı sıra, aileden ve yakın çevreden gizlenmesi nedeniyle tespit edilenden daha sık olarak yaşanan, istismara uğrayan bireyin şimdiki ve gelecekteki yaşantısını olumsuz etkileyen, bu konuda çalışanları oldukça zorlayan bir durumdur. Çocukluk çağı cinsel istismarı, Finkelhor ve Browne’nin travma modelinde ifade edildiği gibi, 4 ana başlık altında incelenen ciddi sorunlara neden olur. Bunlar, zedelenmiş cinsellik, ihanet duygusu, acizlik ve damgalanma şeklinde sıralanabilir. Zedelenmiş cinsellik, cinsel duygu ve davranışların normal gelişiminden sapması olarak tanımlanabilir. Cinsel istismar ve sebep olduğu zedelenmiş cinsellik bireyin cinsel kimlik gelişiminde, çocukluk ve ergenlik dönemi boyunca belirgin bozulmalar şeklinde ortaya çıkar. Cinsel istismar, psikopatolojik anlamda duygudurum bozuklukları ve travma sonrası stres bozukluğuna sebep olabileceği gibi, tekrarlayıcı, rastgele kompulsif davranışlar da ortaya çıkabilir. Bu olgu sunumunda, çocukluk döneminde maruz kaldığı cinsel istismarın uzun dönemdeki etkileri arasında sayılabilecek cinsel obsesyonlar ve kompulsif cinsel davranışlar sergileyen bir olgu sunulmuştur.
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.
Antidepressants and Menstruation Disorders in Women: a Cross-Sectional Study in Three Centers
(Elsevier Science inc, 2012) Uguz, Faruk; Sahingoz, Mine; Kose, Seyit Ali; Ozbebit, Ozgur; Sengul, Cem; Selvi, Yavuz; Askin, Rustem
Objective: The relationship between menstruation disorders and antidepressant drugs usage in women remains unclear. In this study, we aimed to investigate the incidence rate of antidepressant-related menstruation disorders and to examine whether or not antidepressant use is associated with menstrual disorders in women. Methods: The study sample was gathered from three centers and four hospitals. A total of 1432 women who met the criteria of inclusion were included in the study. The sample was divided into two groups: the antidepressant group (n=793) and the control group (n=639). The menstruation disorders were established with reports from the study participants on the basis of related gynecological descriptions. Results: The prevalence of menstrual disorders was significantly higher in the antidepressant group (24.6%) than the control group (12.2%). The incidence of antidepressant-induced menstruation disorder was 14.5%. The antidepressants most associated with menstrual disorders were paroxetine, venlafaxine, sertraline and their combination with mirtazapine. Overall, the incidence rate was similar in women receiving selective serotonin reuptake inhibitors and serotonin noradrenaline reuptake inhibitors. Conclusions: The results of the present study suggest that menstruation disorders are frequently observed in women taking antidepressants and that it appears to be associated with antidepressant use at least in some women. (C) 2012 Elsevier Inc. All rights reserved.
Aripiprazole-Related Acute Transient Myopia and Diplopia a Case Report
(Lippincott Williams & Wilkins, 2011) Selvi, Yavuz; Atli, Abdullah; Aydin, Adem; Yener, Halil Ibrahim
Assessment of the Effects of Antihistamine Drugs on Mood, Sleep Quality, Sleepiness, and Dream Anxiety
(Taylor & Francis Ltd, 2014) Ozdemir, Pinar Guzel; Karadag, Ayse Serap; Selvi, Yavuz; Boysan, Murat; Bilgili, Serap Gunes; Aydin, Adem; Onder, Sevda
Objective. There are limited comparative studies on classic and new-generation antihistamines that affect sleep quality and mood. The purpose of this study was to determine and compare the effects of classic and new-generation antihistamines on sleep quality, daytime sleepiness, dream anxiety, and mood. Methods. Ninety-two patients with chronic pruritus completed study in the dermatology outpatient clinic. Treatments with regular recommended therapeutic doses were administered. The effects of antihistaminic drugs on mood, daytime sleepiness, dream anxiety, and sleep quality were assessed on the first day and 1 month aft er. Results. Outpatients who received cetirizine and hydroxyzine treatments reported higher scores on the depression, anxiety, and fatigue sub-scales than those who received desloratadine, levocetirizine, and rupatadine. Pheniramine and rupatadine were found to be associated with daytime sleepiness and better sleep quality. UKU side effects scale scores were significantly elevated among outpatients receiving pheniramine. Classic antihistamines increased daytime sleepiness and decreased the sleep quality scores. New-generation antihistamines reduced sleep latency and dream anxiety, and increased daytime sleepiness and sleep quality. Conclusion. Both antihistamines, significantly increased daytime sleepiness and nocturnal sleep quality. Daytime sleepiness was significantly predicted by rupadatine and pheniramine treatment. Cetirizine and hydroxyzine, seem to have negative influences on mood states. Given the extensive use of antihistamines in clinical settings, these results should be more elaborately examined in further studies.
The Association of Depression With Treatment and Disability in Multiple Sclerosis
(Turkish Neuropsychiatry Assoc-turk Noropsikiyatri dernegi, 2012) Tanik, Nermin; Aydin, Adem; Selvi, Yavuz; Gulec, Mustafa; Anlar, Omer; Tombul, Temel
Background: To investigate the effects of disability and specific treatments on depression associated with multiple sclerosis (MS). Methods: Fifty-two patients with MS (patient group) and 48 healthy subjects (control group) participated in the study. While the Beck Depression Inventory (BDI) and the Expanded Disability Status Scale (EDSS) were administered to the patients, healthy controls filled out only the BDI. Psychiatric disorders were determined using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Result: Both groups were found to be identical in their socio-demographic properties. The mean age of onset of MS was 29.1 +/- 1.2 years. There was no difference between males and females in terms of depression. The patient group consisted of patients with: relapsing-remitting MS (71.2%), secondary-progressive MS (13.5%), progressive-relapsing MS (11.5%), and primary-progressive MS (3.8%). A 12-fold increased risk for depression was found among patients with MS. Age, attack number and illness duration did not correlate significantly with risk for development of depression in MS. However, a significant relationship was found between EDSS scores and the risk for the development of depression. Depression was detected in patients using azathioprine (100%), interferon beta-1a SC (88.8%) and in patients not receiving any treatment (78.5%). Conclusion: This study indicates that, disability is an important risk factor for the development of depression, irrespective of the treatment modality. (Archives of Neuropsychiatry 2012; 49: 300-303)
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.
Benefits of Submucous Resection on Sleep Quality, Daytime and Dream Anxiety in Patients With Nasal Septal Deviation
(Springer London Ltd, 2013) Gulec, Tezay Cakin; Yoruk, Ozgur; Gulec, Mustafa; Selvi, Yavuz; Boysan, Murat; Oral, Elif; Mazlumoglu, Muhammet R.
The aim of this report was to assess the frequency of poor sleep quality, daytime and dream anxiety and their response to subsequent surgical treatment for a representative group of 68 patients with nasal septum deviation. Nasal airflows and airway resistances were measured using rhinomanometry and the participants were also asked to fill in Pittsburgh Sleep Quality Index, Beck Anxiety Inventory, and Van Dream Anxiety Scale directly before the submucous resection without turbinectomy and 2 months later. Repeated measure analyses of variance models showed that patients reported significantly lower scores of poor sleep quality, daytime anxiety, and as well as dream anxiety after surgical treatment (P < 0.01). Nasal septal surgery might have beneficial effects on sleep variables in patients with deviation.
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)
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).
Chronotype Effects on General Well-Being and Psychopathology Levels in Healthy Young Adults
(Taylor & Francis Ltd, 2013) Gulec, Mustafa; Selvi, Yavuz; Boysan, Murat; Aydin, Adem; Oral, Elif; Aydin, Esat Fahri
Variations in diurnal preferences for activity and sleep have long been classified as morning and evening chronotypes. Although morning and evening-types do not differ in sleep architecture, earlier studies have revealed the association between eveningness and psychopathology. However, most of these works had been conducted only with patient samples. Additionally, previous research has also discovered that morning-types have a healthier lifestyle than evening-types. Therefore, the aim of the present study was to assess the associations between chronotypes and general well-being and psychopathology levels in practically healthy young adults, whose physical and mental health were both examined precisely prior to the research, for the first time in the literature. We found that morning-type individuals have significantly better health conditions than evening-types. And, participants exhibiting a tendency to evening-type were more prone to develop psychological symptoms than subjects exhibiting morning-type chronobiological characteristics. Mental health professionals should be aware that eveningness may be a risk factor for mental and physical health even in currently well young adults.
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.
Çocuk Suçluluğunda Sosyal ve Coğrafi Bölgenin Belirleyici Rolü
(2011) Selvi, Yavuz
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 Superoxide Dismutase, Glutathione Peroxidase and Adenosine Deaminase Activities Between Respiratory and Nocturnal Subtypes of Patients With Panic Disorder
(2010) Özdemir, Osman; Selvi, Yavuz
Son yıllarda serbest oksijen radikallerinin nöropsikiyatrik hastalıkların patofizyolojisinde önemli rol oynadığına dair kanıtlar giderek artmaktadır. Panik bozukluk patogenezinde de serbest oksijen radikallerinin önemli rol oynadığı düşünülmektedir. Panik bozukluk heterojen bir hastalıktır ve panik ataklar farklı belirti kümelerine göre nokturnal, solunumsal, vestibuler, bilişsel ve korkusuz şeklinde alt tiplere ayrılmaktadır.Bu çalışmanın amacı; panik bozukluk hastaları ile sağlıklı kontrol grubunu ve nokturnal tip ile solunumsal tip panik bozukluk hastalarını antioksidan kapasiteyi ölçen Glutatyon Peroksidaz, Süperoksit Dismutaz ve T hücre ile ilişkili enzim olan Adenozin Deaminaz düzeyleri açısından karşılaştırmaktır. Böylece panik bozuklukta ve alt tipler arasında oksidatif stresin ve inflamatuar süreçlerin rolünü araştırmaktır.Çalışmamızda hasta grubunda kontrol grubuna oranla SOD ve GSH-Px kan düzeyleri daha düşük, ADA enzim düzeyleri ise daha yüksek bulundu. Nokturnal ve solunumsal alt tiplerin enzim düzeyleri arasında anlamlı farklılık bulunmadı. Alt tiplerin PAS toplam, HAM-A, HAM-D puanları ve hastalık süreleri karşılaştırıldığında; PAS toplam ve hastalık süresi açısından fark bulunmadı, nokturnal alt tipin HAM-D ve HAM-A puanları solunumsal alt tipe göre daha yüksek bulundu. Bu değişkenlerle enzim düzeyleri arasındaki ilişki incelendiğinde sadece hastalık süresi ile GSH-Px serum düzeyleri arasında pozitif bir ilişki bulundu.Sonuç olarak panik bozukluk hastalarının SOD ve GSH-Px, ADA enzimleri düzeyleri kontrol grubundan farklı bulunmuştur. Panik bozukluk grubunda SOD, GSH-Px antioksidan enzim düzeylerinin düşük bulunması panik bozuklukta oksidatif stres yükünün fazla olduğunu, ayrıca hücresel immünitenin bir göstergesi olan ADA enzim düzeylerinin yüksek bulunması bu rahatsızlıkta inflamatuvar süreçlerin de rol oynadığını düşündürmektedir. Alt tiplerin enzim düzeyleri arasında fark bulunmaması bu klinik görünümlerin aynı hastalığın farklı semptom kümeleri olduğunu desteklemektedir.Anahtar sözcükler: panik bozukluk, alt tipler, oksidatif stres
Comparison of Venlafaxine Alone Versus Venlafaxine Plus Bright Light Therapy Combination for Severe Major Depressive Disorder
(Physicians Postgraduate Press, 2015) Ozdemir, Pinar Guzel; Boysan, Murat; Smolensky, Michael H.; Selvi, Yavuz; Aydin, Adem; Yilmaz, Ekrem
Objective: Phototherapy, ie, bright light therapy, is an effective and safe treatment of major depressive disorder (MDD). It exerts rapid mood-elevating activity, similar to antidepressant medications, most likely mediated through both monoaminergic and circadian system melatonergic mechanisms. We assessed the efficiency of bright light therapy as an adjuvant treatment to antidepressant pharmacotherapy in patients with severe MDD randomized by Hamilton Depression Rating Scale (HDRS) score to either (1) 150 mg venlafaxine hydrochloride daily at 7: 00 am or (2) 150 mg venlafaxine plus 60-minute light of 7000 lux the initial week of clinical management (venlafaxine + bright light therapy) daily at 7: 00 am. Method: 50 inpatients with severe MDD at the Psychiatry Clinic of Yuzuncu Yil University Training and Education Hospital participated. The study, which was conducted from January 2013 through June 2014, entailed patients diagnosed with severe MDD based on DSM-IV-TR for the first time. Mood states were assessed by the HDRS, Profile of Mood States (POMS), and Beck Depression Inventory (BDI) before treatment and at 1, 2, 4, and 8 weeks of treatment. Results: On the basis of the HDRS score as the primary outcome variable, both strategies significantly improved depression and negative mood states already at the first treatment week (P < .001). Differences in therapeutic effects by treatment strategy were remarkable at the second and fourth weeks of clinical management (P = .018 and P = .011, respectively), with beneficial effects continuing until trial Conclusion. Those treated with venlafaxine + bright light therapy evidenced significantly lower HDRS depression scores (P < .05) as well as BDI scores (P < .05) and POMS negative mood states scores (depression-dejection, tension-anxiety, anger-hostility, fatigue-inertia, and confusion-bewilderment subscales; all P < .05) after the second week. At week 4 of the trial, 19 (76%) of the 25 venlafaxine + bright light therapy patients versus just 11 (44%) of the 25 venlafaxine patients (P < .05) attained the target goal of treatment, a HDRS score = 13, indicative of mild depression, and, although not statistically significant in our small sample study (P = .36), at week 8, 76% of venlafaxine + bright light therapy patients (n = 19) versus just 64% of the venlafaxine patients (n = 16) experienced complete remission of depression (HDRS score = 7). Conclusions: Both venlafaxine and venlafaxine + bright light therapy treatment strategies significantly reversed the depressive mood of patients with severe MDD; however, the latter induced significantly stronger and more rapid beneficial effects. Future longer-term studies with large sample sizes, nonetheless, are required to confirm and generalize these results to patients of diverse ethnicities and cultures with both severe and mild MDD. (C) Copyright 2015 Physicians Postgraduate Press, Inc.
Datura Stramonium Intoxication: Report of a Case With Psychiatric Symptoms
(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2011) Karadas, Sevdegul; Selvi, Yavuz; Sahin, Mustafa; Selvi, Fatih; Oncu, Resit; Ozgokce, Fevzi
Delirium is a common neuropsychiatric syndrome and is often caused by metabolic, systemic disorders and drug or poison intoxication. Though hallucinations, delusions and agitation are sometimes present, the symptoms of delirium are clinically distinct from those induced by other psychiatric disorders. Datura stramonium is a hallucinogenic plant which is a member of belladona alkaloids. The toxic effects of Datura stramonium most often include visual and auditory hallucinations, confusion and agitation. We report a patient who was poisoned with Datura stramonium and presented to the emergency department with psychiatric symptoms.