Explore the vast range of titles available.

Schizophrenia presents with different symptom domains and functionality during its course. Obsessive-compulsive (OC) symptoms in schizophrenia have many themes to be clarified. Our aim was to compare schizophrenia patients with and without OC symptoms in terms of symptom domains, cognitive functions, and quality of life. Sixty-two patients who met schizophrenia diagnosis were assessed with Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition consecutively over a period of 12 months in the setting of an outpatient clinic at medical university hospital. Yale-Brown Obsessive-Compulsive Scale, Scale for the Assessment of Negative Symptoms, Scale for the Assessment of Positive Symptoms, and neuropsychologic tests were used. Quality of life was assessed with Quality of Life Scale for Patients with Schizophrenia. Obsessive-compulsive symptoms along with schizophrenia were present in a considerable number in our sample (35.5%). Level of psychotic symptoms was more severe and quality of life was lower in schizophrenia patients with OC symptoms. A positive correlation was found between obsessions and delusions. Moreover, there was a positive correlation between compulsions and total Scale for the Assessment of Positive Symptoms score and bizarre behaviors subscore. There was no difference between the 2 groups regarding neurocognitive functions. The level of quality of life of schizophrenic patients with OC symptoms was lower. Besides, no correlation was found between OC symptoms and neurocognition and quality of life. The findings of this study indicate that schizophrenia patients with OC symptoms had severe psychotic symptoms with a distinctive clinical picture including good neurocognition but poor functioning.

Objective: Attention-deficit hyperactivity disorder (ADHD) with other psychiatric comorbidities in adulthood is chal-lenging in terms of differentiating the neuropsychological impairments in each disorder. Executive functions have been widely studied and shown to be consistently impaired in ADHD. However, there is a lack of knowledge about which executive function deficits are attributable to ADHD and which of them are assosciated with comorbid psychiatric disorders. Thus, the aim of this study was to investigate to what extent the deficits in executive functions are attributable to ADHD rather than comorbid psychiatric diseases among adult patients with ADHD. Methods: Adult patients diagnosed with ADHD and comorbid psychiatric disorders (n=26) were compared with psychiatric patients without ADHD (n=26) and healthy subjects (n=26) matched for age, sex, and duration of education. Adult ADHD Self-Report Scale, Wender Utah Rating Scale for the ADHD and Structured Clinical Interview for DSM-IV Axis I Disorders screened all participants. In addition, Wisconsin Card Sorting Test computer form, Rey Auditory Verbal Learning Test, and the Stroop Color Word Test were used for neuropsychological assessment. Results: Adults psychiatric patients with ADHD scored lower than those without ADHD in terms of measures of inhibition, attention, planning, set-shifting, problem-solving, verbal learning, and verbal memory. Psychiatric patients without ADHD scored significantly lower than healthy controls in terms of planning and problem solving. Conclusions: Our findings suggest that the ADHD, rather than comorbid psychiatric disorders, is the significant underlying cause for executive function deficits in inhibition, attention, set-shifting, verbal learning, and verbal memory. (Anatolian Journal of Psychiatry 2019; 20(1):84-92)

Antipsychotic drugs can cause neutropenia which can progress to life-threatening agranulocytosis. Clozapine is well-known for this side effect which is rare for other antipsychotics. Quetiapine is a newer atypical antipsychotic which shows similarities with clozapine in chemical structure. We present a rare case of neutropenia and thrombocytopenia induced by quetiapine monotherapy of 600 mg/day in a 69-yearold patient with the diagnosis of bipolar I disorder. Hematological adverse effects were resolved by the discontinuation of quetiapine treatment. Although monitoring blood counts during quetiapine use is not recommended, clinicians should be aware of this rare but hazardous side effect.

Valproic acid (VPA) is used as a mood stabilizer in the treatment of bipolar disorder and is commonly associated with central nervous system side effects. The most common side effect is tremor due to dose, while parkinsonism is a less common side effect. Among psychiatric patients, there are few reports of recurrent parkinsonism attributed to VPA use. However, in the literature, especially among neurological patients, VPA is one of the main important causes of Parkinsonism. Furthermore, the relationship between VPA treatment dose and parkinsonism symptom severity is uncertain. 72-year-old male patient has been followed-up for 30 years with a diagnosis of bipolar disorder and has been receiving a treatment of VPA. After VPA treatment was started, complaints of impairment in speech, walking with small steps, slowed movements, and imbalance which had gradually increased, started within the last 10 years. The patient was admitted to the clinic and assessed for secondary parkinsonism. VPA treatment of the patient was stopped since he was thought to have secondary parkinsonism associated with medication. 4 days after the VPA medication was stopped, it was seen that there was a decrease in bending forward posture and regression in dysphagia and the patient was seen to walk alone without any support. Based on this case, it can be put forward that addressing psychiatry patients who have a long-term use of VPA in terms of parkinsonism symptoms can be significant in terms of not overlooking this side effect that can disrupt the quality of life and also in terms of early diagnosis and treatment.

Aim: Characteristically, the onset of bipolar disorder is the early adulthood and the first episode affects women of childbearing age. The studies indicate that 60-70 % of women with bipolar disorder experince mood symptoms during the periods of pregnancy and/or postpartum. The aim of the present study is to reveal the risk of bipolar disorder in pregnancy and the risk of bipolar disorder among pregnant women who had positive screening for prenatal depression. Methods: The study involved 347 literate pregnant women between the ages of 18-50. All patients were screened with self-report scales of Edinburgh Postnatal Depression Scale (EPDS) and Mood Disorders Questionnaire (MDQ). Results: Of the 347 women participating in the study, completed both scales. Of the participants, 52 (16.5%) EPDS scale was found to be positive while 27 (8.5%) MDQ scale was positive. Diagnosis of bipolar disorder was considered in 3 (%11.1) out of 27 individuals who had MDQ score of 7 or above by a clinical interview with SCID-I. The results also indicated that the probability of positive EPDS screening is significantly higher than negative screening in participants with positive MDQ screen (p [PBS 2018; 8(4.000): -]

Objective: Previous research has suggested that metabolic syndrome is more prevalent among patients with schizophrenia and bipolar disorder. Given the scarcity of comparative research on these disorders, this study aims to compare the prevalence of metabolic syndrome in two diagnostic groups and to identify sociodemographic or clinical factors related to metabolic syndrome. Methods: A total of 235 patients diagnosed with schizophrenia (n=160) and bipolar disorder (n=75) and were being followed up by a metabolic monitoring program in a specialized outpatient clinic and using antipsychotic therapy for at least eight weeks have participated in this cross-sectional study. Patients were diagnosed with metabolic syndrome according to National Cholesterol Education Program Adult Treatment Panel-III (NCEP ATP-III) criteria. Sociodemographic and clinical data including metabolic records were collected retrospectively by reviewing the patients’ medical records. Results: The overall prevalence of meta-bolic syndrome was 32.3% and waist circumference was the most frequent individual component with a prevalence of 60%. There were no differences in the prevalence of metabolic syndrome between schizophrenia and bipolar patients. Age, body mass index (BMI), and use of certain types of atypical antipsychotics were found related to metabolic syndrome. Conclusion: The prevalence of metabolic syndrome and its components among patients with severe mental illness is alarming irrespective of their diagnoses. Thus, metabolic screening is crucial especially for high-risk groups. (Anatolian Journal of Psychiatry 2018; 19(4):346-354)

Vaginismus is a female sexual dysfunction with reflex spasm of the muscles around vagina making penile penetration impossible. Many factors such as psychological, social and cultural may cause vaginismus were proposed, but debates are still ongoing. In this study, factors that may be related with vaginismus were studied and compared with controls. Methods: The participants were women with vaginismus without any organic pathology in gynecological examination and healthy controls. Twenty-five women with vaginismus and 25 controls who have no difficulty with vaginal penetration were evaluated by self-reported scales for depression, anxiety and sexual function. Sociodemographic variables were collected for each participants. Results: Women with vaginismus did not differ from controls in sociodemographic characteristics. The women with vaginismus had significantly higher levels of depression and anxiety. Total score of Glombok-Rust Sexual Satisfaction Scale, subscores of vaginismus, satis-faction, avoidance, anorgasmia were significantly higher and level of sexual knowledge was also limited in women with vaginismus. Discussion: Multiple sociodemographic and clinical factors are found associated with vaginismus. Some of the findings are supported by the literature but some are not. This may remind us there are still unclear concerning related factors in vaginismus. So, there is need for further studies in which hypotheses of different etio-pathologies of vaginismus will be held.

OBJECTIVES: Bipolar disorder (BD) is a chronic psychiatric disorder with a high prevalence of obesity. There are a number of hypotheses regarding the association between obesity and BD. One involves common neurobiological abnormalities, such as dysfunction in the hypothalamic pituitary adrenal axis and changes in secretions of orexigenic and anorectic peptides. The purpose of this study was to evaluate the blood levels of agouti-related peptide (AgRP), obestatin cortisol, and corticosteroid-binding globulin (CBG) and metabolic parameters in patients with euthymic BD, and to compare these to those of healthy controls. METHODS: Twenty-nine outpatients with BD type I admitted to the psychiatric clinic were consecutively enrolled and compared with 25 sex- and body mass index (BMI)-matched controls. RESULTS: There was a significant difference in AgRP, cortisol, and CBG levels between patients and the controls (p = .005, .021, and .034, respectively). AgRP and CBG did not correlate with any parameter in BD patients, but cortisol correlated with BMI. CONCLUSIONS: We conclude that BD patients have higher levels of AgRP, cortisol, and CBG than healthy controls with similar BMIs. This may represent a new insight into the neurobiology of BD.

Olanzapine, quetiapine and aripiprazole have been shown to be effective treatments for bipolar depression. However, induction of manic and depressive episodes with atypical antipsychotic treatments have also been described as risk. Current literature described antidepressant effects of Aripiprazole with the risk of manic shift. In this report, a case who developed manic episode with the treatment of 30mg/day of the aripiprazole will be discussed. A 35-year-old, woman, who had 12 years history of bipolar affective disorder-I (BAD-I) for 12 years, and taking paliperidone 9mg/day and lithium 1200mg/day for the last 14 months. She was admitted to outpatient clinic by her parents with complaints of fatigue, loss of pleasure and increased sleep. She was suspicious, had thoughts of getting harm form others and being a sinner, and suspecting that someone put a spell on her. She was admitted to inpatient service with the diagnosis of BAD-I depressive episode with psychotic features. Aripiprazole 30mg/day was added to current treatment regime. Consequently, increase in targeted activities, inappropriate affect, decreased need for sleep, and grandiose delusions were observed. The symptoms of mania were considered to be induced by aripiprazole, and its dose was decreased to 10mg/day. Following the dose reduction, sleepiness and her delusions were improved within the consecutive 2 weeks.

Background: In this study, we aimed to investigate the possible effects of sertraline on blood glucose and lipid levels as risk factors for cardiovascular disease in depressive patients. Methods: Eight male and twelve female depressive patients, diagnosed according to DSM-IV criteria, were included in this study. The subjects aged 19-50 years, did not smoke, and had normal body mass index (BMI), homeostasis model assessment-estimated insulin resistance (HOMA-IR) values, blood pressure, blood glucose, insulin and lipid levels. Sertraline therapy (50 mg/day) was started. Patients with diabetes mellitus, heart disease, pregnancy, and those taking other drugs were excluded from the study. Blood glucose, insulin, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), and triglyceride values were measured in patients before, and at the 4 th, 8th and 12th weeks after treatment with sertraline. Moreover, HbA1C levels were measured at the beginning and at the end of the treatment (at 12th weeks). Results: There were no significant differences in physical examination (blood pressure, BMI, body weight, height, waist circumference) and laboratory findings (glucose, HDL-C, LDL-C, HOMA-IR and HbA1C levels) at the 12th week after of treatment with sertraline compared to pretreatment values. However, insulin levels at the 4 th, 8th and 12th weeks significantly increased compared with pretreatment values. Likewise, triglyceride levels at the 8th and 12th weeks significantly increased compared with pretreatment values. Conclusions: Sertraline-treated patients have to be followed up for blood insulin and triglyceride levels. In addition, their treatment plan needs to be adjusted as necessary to prevent possible metabolic changes.