Browsing by Author "Yildirim, Abdullah"

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Associations Between Sleep Quality, Severity of Dissociation, Pathological Worry, and Functional Impairment in Multiple Sclerosis: a Case-Control Study
(Kare Publ, 2020) Yildirim, Abdullah; Boysan, Murat; Cilingir, Vedat
Objective: The current study was designed to investigate differences between patients with multiple sclerosis (MS) and healthy controls regarding sleep quality, worry, and dissociative experiences. We also explored the potential correlates of functional impairment in this group. Method: Eighty-eight patients with MS and 139 healthy adults participated in the study. The mean age was 30.96 (standard deviation=8.88) years. The Expanded Disability Status Scale, Dissociative Experiences Scale (DES), Penn State Worry Questionnaire (PSWQ), and Pittsburgh Sleep Quality Index (PSQI) were completed by clinical and nonclinical subjects. Binary logistic and multiple regression analyses were performed. Results: Of the MS patients, 55.7% were identified as poor sleepers. However, total scores on the PSQI did not differ significantly between clinical and nonclinical subjects. Logistic regression analysis showed that patients with MS reported significantly lower levels of habitual sleep efficiency than healthy controls. Interestingly, healthy adults reported higher scores on pathological worry than patients with MS. Patients with MS and healthy adults did not differ in the DES scores. Duration of illness and worrisome thoughts were significant predictors of the functional impairment occurring during the course of the illness. Conclusion: Patients with MS had poor habitual sleep efficiency, which may be a significant risk factor for management and improvement of the illness. Pathological worry seems to be associated with disability status. Cognitive behavioral interventions including sleep-informed instructions should be integrated into clinical practices to enhance positive outcomes during the course of the treatment in this group.
A Case of Encephalitis Presenting With Depressive Symptoms
(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2015) Ozdemir, Pinar Guzel; Cecen, Hulya; Ozdemir, Osman; Yildirim, Abdullah
Childhood Maltreatment Is Associated With Attachment Insecurities, Dissociation and Alexithymia in Bipolar Disorder
(Elsevier Ireland Ltd, 2018) Kefeli, Mehmet Celal; Turow, Rachel Goldsmith; Yildirim, Abdullah; Boysan, Murat
Child maltreatment is a public health issue that is a well-established risk factor for many psychological conditions, including bipolar disorder. The current study is one of the first to investigate associations among child maltreatment, dissociative symptomatology, alexithymia, anxiety, depression, and attachment insecurities. 40 patients with bipolar disorder-I and 40 healthy subjects matched for age, gender, and education participated in the study. The Dissociative Experiences Scale (DES), Somatoform Dissociation Questionnaire (SDQ), Childhood Trauma Questionnaire (CTQ-28), Toronto Alexithymia Scale (TAS-20), Depression Anxiety Stress Scale (DASS-21), and Experiences in Close Relationships-Revised (ECR-R) were completed by participants. In comparison to control participants, patients with bipolar disorder-I reported significantly more frequent abusive experiences in childhood, higher levels of attachment insecurities, more severe pathological and somatoform dissociation, as well as higher scores on measures of alexithymia, anxiety, depression and psychological stress. Reports of psychopathology among first-degree relatives (OR = 102.169, 95%IC = 4.596-2271.255; P < 0.01) and childhood emotional trauma (OR = 1.032; 95%CI = 0.782-1.363, P = 0.05) significantly contributed to bipolar disorder-I diagnosis. In contrast, absorption was negatively associated with bipolar illness (OR = 0.852; 95% CI = 0.747-0.973, P < 0.05). Our results showed significant associations between childhood trauma exposure and risk of bipolar disorder. Moreover, the results demonstrate that emotional abuse exposure predicts bipolar illness.
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.
Heterogeneity of Sleep Quality Based on the Pittsburgh Sleep Quality Index in a Community Sample: a Latent Class Analysis
(Springer Japan Kk, 2017) Yildirim, Abdullah; Boysan, Murat
This study aims to assess the latent dimensional structure of sleep quality as measured by seven components of the Pittsburgh Sleep Quality Index (PSQI) and evaluate its diagnostic utility in discriminating individual differences on circadian preferences. Three hundred sixty-seven subjects, aged 17-58 years (mean 22.3 +/- 6.3) and 55% female, participated in the study. The PSQI and Morningness-Eveningness Questionnaire (MEQ) were administered, and latent class analysis was run to assess latent homogeneous subgroups according to seven components of the PSQI. Latent class analysis revealed that sleep quality is multifaceted, and data distribution fits best to two-class model. About two-thirds of the subjects (n = 289) were classified into poor sleep quality class and 78 participants were grouped into good sleep quality class. A PSQI total >= 5 was identified as the cut-off value for an optimal discrimination between these two latent classes. Three-step regression analysis did not demonstrate a significant relationship between circadian preferences and sleep quality. Finally, signal detection analysis showed that the PSQI total cut-off value had low diagnostic utility with respect to the individual variation in circadian preferences. Sleep quality is a distinct psychological construct from circadian preferences. Sleep problems were prevalent in the study population and developmentally sensitive sleep programs are required.
Metabolic Parameters in Patients With Major Depression Treated With Escitalopram
(Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2016) Demirci, Onur Okan; Fistikci, Nurhan; Sagaltici, Eser; Karamustafalioglu, Nesrin; Yildirim, Abdullah; Ilnem, Mehmet Cem
Objective: The aim of this study is to determine the change in metabolic parameters of patients with major depression treated with escitalopram. Methods: The height, body weight, waist circumference, blood pressure, lipid profile (total cholesterol, low density lipoprotein [LDL], high density lipoprotein [HDL], triglycerides [TG]), fasting blood glucose (FBG), thyroid stimulating hormone (TSH) and Hamilton Depression Scale (HamD) of 41 consecutively selected patients with major depression were measured before treatment and in the third month of treatment, for whom a decision to start treatment with escitalopram was decided. The relationship between treatment and changes in these metabolic parameters were evaluated at the end of this period. Results: The mean age of patients was 30.24 +/- 9.96 (18-62) years. Eleven (27%) patients were male and 30 (73%) were female. Twelve (29.3%) patients were treated with 10 mg/day escitalopram, and 29 patients (70.7%) 20 mg/day. Significant increases were detected in body weight, body mass index, waist circumference and systolic blood pressures of all patients from initiation of treatment to three months. A significant increase was found in the waist circumference of male patients (n= 11) after three months of treatment. Body weight, body mass index, waist circumference, triglycerides, systolic blood pressure were found to be significantly increased after three months of treatment in female patients (n= 30) who were treated with escitalopram. HamD scores were found to be significantly decreased after three months in patients treated with escitalopram. Conclusion: Escitalopram caused an increase in especially body weight and waist circumference in patients with major depression.
Neurological Soft Signs, Dissociation and Alexithymia in Patients With Obsessive-Compulsive Disorder (Ocd) and Healthy Subjects
(Elsevier Ireland Ltd, 2018) Tapanci, Zafer; Yildirim, Abdullah; Boysan, Murat
A body of evidence has supported that patients with obsessive-compulsive disorder (OCD) have increased rates of various neurological soft signs (NSS) compared to controls. Various lines of research has documented robust relationships between OCD and dissociative symptomatology. The study aimed to examine the associations between obsessive-compulsive symptoms, dissociative experiences alexithymia, and NSS. The study included thirty OCD patients and thirty healthy controls, matched for age, marital status, education, and income. The Neurological Evaluation Scale (NES), Padua Inventory-Revised (PI-R), Dissociative Experiences Scale (DES) and Toronto Alexithymia Scale (TAS-20) were administered. In comparison to healthy controls, patients with OCD had difficulty sequencing for complex motor acts and greater absorption/imaginative involvement. Using latent class analysis, the study sample was classified into two homogenous subsets as mild NSS (n = 45) and severe NSS (n = 15). Majority of the participants who were grouped into severe NSS latent class were OCD patient (n = 14, 93.3%). Furthermore, those with severe NSS reported greater levels of alexithymia and more severe obsessive -compulsive symptoms, particularly precision. We concluded that relationships between OCD severity and NSS appear to be of crucial importance. Our data along with accumulated evidence suggest that OCD associated with pronounced NSS may represent a specific subtype of the disorder.
Psychometric Properties of the Turkish Version of the Depression Anxiety Stress Scale-21 (dass-21)
(Routledge Journals, Taylor & Francis Ltd, 2018) Yildirim, Abdullah; Boysan, Murat; Kefeli, Mehmet Celal
The study examined the psychometric properties of the Turkish version of the DASS-21. Thirty patients with major depression and 30 patients with anxiety disorders and 250 health controls participated in the study. We tested six alternative models using CFA. We found that tripartite model comprised of anhedonia and physiological hyperarousal along with a general negative affectivity outperformed alternative models. The DASS-21 distinguished clinical groups from healthy controls. The scale had excellent internal reliability, with Cronbach's alphas ranging from 0.87 to 0.90, and temporal stability, with intra-correlations ranging from 0.82 to 0.93. The Turkish version of the DASS-21 appears to have adequate psychometric properties in clinical and non-clinical samples.
Psychometric Properties of the Turkish Version of the Sleep Hygiene Index in Clinical and Non-Clinical Samples
(W B Saunders Co-elsevier inc, 2015) Ozdemir, Pinar Guzel; Boysan, Murat; Selvi, Yavuz; Yildirim, Abdullah; Yilmaz, Ekrem
Objective: Sleep is one of the most significant of human behaviors, occupying roughly one third of human life. Sleep is a process the brain requires for proper functioning. Sleep hygiene can be described as practices to ease sleep and to avoid factors which decrease sleep quality. Inadequate sleep hygiene generally results in disturbance of daily life activities due to inability to sustain sleep quality and daytime wakefulness. Therefore, the importance of development and utilization of measures of sleep hygiene increases. The aim of the study was to assess psychometric properties of the Sleep Hygiene Index (SHI) in clinical and non-clinical Turkish samples. Method: Data were collected from 106 patients with major depression consecutively admitted to the psychiatry clinic of Yuzuncu Yil University School of Medicine and 200 were volunteers recruited from community sample who were enrolled at the university. The SHI, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI) and Epworth Sleepiness Scale (ESS) were administered to the subjects. Factor structure of the SHI was evaluated with explanatory and multi-sample confirmatory factor analyses. Pearson product-moment correlation coefficients of the SHI with the PSQI, IST and ESS were computed. Item analyses, internal consistency coefficients and intra-class correlations between two repeated applications in both patient and healthy subjects were calculated. Results: The Sill revealed a unidimensional factor structure. Significant strong partial associations of the SHI with depression, insomnia and poor sleep quality and a modest partial association with sleepiness were detected. Cronbach's alphas for the SHI in community sample and patients with major depression were 0.70 and 0.71, respectively. Additionally, we found acceptable three-week temporal reliability in terms of intra-correlation coefficients of r = 0.62, p < 0.01 for the community sample and of r = 0.67, p < 0.01 among patients with major depression. Conclusion: The SHI revealed adequate validity and reliability to be used by researchers in Turkish sample. Current results were discussed in light of previous findings and theoretical considerations. (C) 2015 Elsevier Inc. All rights reserved.
Rectal Indomethacin Use in Pain Relief During Hysterosalpingography: a Randomized Placebo Controlled Trial
(Wiley, 2016) Karaman, Erbil; Cim, Numan; Alkis, Ismet; Yildirim, Abdullah; Yildizhan, Recep
AimTo evaluate the effectiveness of a rectal nonsteroidal anti-inflammatory drug (indomethacin) for pain relief during a hysterosalpingography (HSG). Materials and MethodsThis prospective, randomized study included 82 women divided randomly into two groups. The study group received self-administered rectal indomethacin, while the control group received a placebo before the procedure. Degrees of pain were evaluated using the visual analog scale (VAS) at four different steps during the procedure and 30 min afterwards. The anxiety-depression status of the patients was evaluated using a validated Turkish version of the Beck anxiety-depression form before the procedure. ResultsThere were no statistically significant differences in the demographic characteristics of patients. The mean pain scores during tenaculum application (step 2), cervical traction (step 3), contrast injection (step 4) and 30 min after the procedure, were significantly lower in the study than the control group (P < 0.05). Step 4 was the most painful in both groups (VAS scores 3.2 0.6 study vs 5.3 +/- 1.1 control). The mean pain score in step 4 for patients with abnormal HSG results was significantly higher than in patients with normal HSG results (P < 0.05). The mean anxiety and depression scores immediately before the procedure were not statistically different between the groups (P = 0.610 and P = 0.129, respectively). ConclusionOur study demonstrated a significant reduction in pain in patients who received a single rectal dose of indomethacin; therefore, we recommend the use of rectal indomethacin for reducing pain during a HSG procedure.
Relationships Between Probabilistic Inferences, Meta-Cognitions, Obsessional Beliefs, Dissociative Experiences and Obsessive-Compulsive Symptoms: a Mixture Structural Equation Modeling Approach
(Springer, 2022) Boysan, Murat; Yildirim, Abdullah; Okmen, Anil Cemre
A dissociative tendency in obsessive-compulsive disorder (OCD) has long been documented. It is recognized that dissociative symptoms in OCD may interfere with response to treatment. The current study investigated whether cognitive vulnerability factors are differentially associated with dissociative experiences and obsessive-compulsive (O-C) symptoms in a general population sample. Moreover, using the mixture structural equation modeling (MSEM) approach, we explored whether a latent psychopathological profile exists that may differ in severity of dissociation, O-C symptoms, and cognitive vulnerability factors in the sample. The structural equation analysis showed that probabilistic inferences directly contributed to the variances of both dissociative and O-C symptoms. Probabilistic inferences mediated the relationships of meta-cognitions with both dissociation and O-C symptoms. Obsessional beliefs were directly associated with O-C symptoms and indirectly contributed to dissociation via obsessions. Two latent profiles emerged in the MSEM: a healthy group and a psychopathological group. Participants classified into the latent psychopathological profile were high in O-C symptoms and dissociation as well as cognitive vulnerability factors of meta-cognitions, obsessional beliefs, and probabilistic inferences. The mixture analysis provided further support for the significant associations between the variables of interest. Further research is needed to better understand the underpinnings of the relationships between O-C symptoms and dissociation.
Treatment Delays and In-Hospital Outcomes in Acute Myocardial Infarction During the Covid-19 Pandemic: a Nationwide Study
(Kare Publ, 2020) Erol, Mustafa Kemal; Kayikcioglu, Meral; Kilickap, Mustafa; Guler, Arda; Yildirim, Abdullah; Kahraman, Fatih; Genc, Omer
Objective: Delayed admission of myocardial infarction (MI) patients is an important prognostic factor. In the present nationwide registry (TURKMI-2), we evaluated the treatment delays and outcomes of patients with acute MI during the Covid-19 pandemic and compaired with a recent pre-pandemic registry (TURKMI-1). Methods: The pandemic and pre-pandemic studies were conducted prospectively as 15-day snapshot registries in the same 48 centers. The inclusion criteria for both registries were aged >= 18 years and a final diagnosis of acute MI (AMI) with positive troponin levels. The only difference between the 2 registries was that the pre-pandemic (TURKMI-1) registry (n=1872) included only patients presenting within the first 48 hours after symptom-onset. TURKMI-2 enrolled all consecutive patients (n=1113) presenting with AMI during the pandemic period. Results: A comparison of the patients with acute MI presenting within the 48-hour of symptom-onset in the pre-pandemic and pandemic registries revealed an overall 47.1% decrease in acute MI admissions during the pandemic. Median time from symptom-onset to hospital-arrival increased from 150 min to 185 min in patients with ST elevation MI (STEMI) and 295 min to 419 min in patients presenting with non-STEMI (NSTEMI) (p-values <0.001). Door-to-balloon time was similar in the two periods (37 vs. 40 min, p=0.448). In the pandemic period, percutaneous coronary intervention (PCI) decreased, especially in the NSTEMI group (60.3% vs. 47.4% in NSTEMI, p<0.001; 94.8% vs. 91.1% in STEMI, p=0.013) but the decrease was not significant in STEMI patients admitted within 12 hours of symptom-onset (94.9% vs. 92.1%; p=0.075). In-hospital major adverse cardiac events (MACE) were significantly increased during the pandemic period [4.8% vs. 8.9%; p<0.001; age- and sex-adjusted Odds ratio (95% CI) 1.96 (1.20-3.22) for NSTEMI, p=0.007; and 2.08 (1.38-3.13) for STEMI, p<0.001]. Conclusion: The present comparison of 2 nationwide registries showed a significant delay in treatment of patients presenting with acute MI during the COVID-19 pandemic. Although PCI was performed in a timely fashion, an increase in treatment delay might be responsible for the increased risk of MACE. Public education and establishing COVID-free hospitals are necessary to overcome patients' fear of using healthcare services and mitigate the potential complications of AMI during the pandemic.