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Tobe RH, Tu L, Keefe JR, Breland MM, Ely BA, Sital M, Richard JT, Tural U, Iosifescu DV, Gabbay V. Personality characteristics, not clinical symptoms, are associated with anhedonia in a community sample: A preliminary investigation. J Psychiatr Res 2023; 168:221-229. [PMID: 37922596 DOI: 10.1016/j.jpsychires.2023.10.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 10/16/2023] [Accepted: 10/25/2023] [Indexed: 11/07/2023]
Abstract
Anhedonia is a salient transdiagnostic psychiatric symptom associated with increased illness severity and chronicity. Anhedonia is also present to varying degrees in non-clinical cohorts. Here, we sought to examine factors influencing expression of anhedonia. Participants (N = 335) were recruited through the Nathan Kline Institute-Rockland Sample, an initiative to deeply phenotype a large community sample across the lifespan. Utilizing a data-driven approach, we evaluated associations between anhedonia severity, indexed by Snaith-Hamilton Pleasure Scale (SHAPS), and 20 physical, developmental, and clinical measures, including Structured Clinical Interview for DSM-IV, Beck Depression Inventory, State-Trait Anxiety Inventory, NEO Five-Factor Inventory-3 (NEO-FFI-3), BMI, Hemoglobin A1C, and demography. Using a bootstrapped AIC-based backward selection algorithm, seven variables were retained in the final model: NEO-FFI-3 agreeableness, extraversion, and openness to experience; BMI; sex; ethnicity; and race. Though median SHAPS scores were greater in participants with psychiatric diagnoses (18.5) than those without (17.0) (U = 12238.5, z = 2.473, p = 0.013), diagnosis and symptom measures were not retained as significant predictors in the final robust linear model. Participants scoring higher on agreeableness, extraversion, and openness to experience reported significantly lower anhedonia. These results demonstrate personality as a mild-to-moderate but significant driver of differences in experiencing pleasure in a community sample.
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Affiliation(s)
- Russell H Tobe
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, 10962, USA; Center for the Developing Brain, Child Mind Institute, New York, NY, 10022, USA.
| | - Lucia Tu
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, 10962, USA
| | - John R Keefe
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Melissa M Breland
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, 10962, USA
| | - Benjamin A Ely
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Melissa Sital
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, 10962, USA
| | - Jasmin T Richard
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, 10962, USA; Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Umit Tural
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, 10962, USA
| | - Dan V Iosifescu
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, 10962, USA; Department of Psychiatry, New York University School of Medicine, New York, NY, 10016, USA
| | - Vilma Gabbay
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, 10962, USA; Department of Psychiatry and Behavioral Sciences, University of Miami Leonard M. Miller School of Medicine, Coral Gables, FL, 33124, USA
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Cho Y, Tural U, Iosifescu DV. Efficacy of Transcranial Photobiomodulation on Depressive Symptoms: A Meta-Analysis. Photobiomodul Photomed Laser Surg 2023; 41:460-466. [PMID: 37651208 PMCID: PMC10518694 DOI: 10.1089/photob.2023.0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/28/2023] [Indexed: 09/02/2023] Open
Abstract
Background: Transcranial photobiomodulation (tPBM) is a novel, noninvasive, device-based intervention, which has been tested as a possible treatment for various neurological and psychiatric conditions. Recently, it has been investigated as an innovative treatment for major depressive disorder (MDD). There have been several animal and clinical studies that evaluated the underlying mechanism and the efficacy of its antidepressant effects, but results have been conflicting. Objective: Thus, we conducted the first meta-analysis on effects of tPBM on depressive symptoms. Materials and methods: Thirty original articles on tPBM were retrieved, eight of them met criteria for inclusion to a random effects meta-analysis. Results: tPBM appeared effective in decreasing depressive symptom severity regardless of diagnosis (Hedges' g = 1.415, p < 0.001, k = 8), but a significant heterogeneity has been found. The meta-analysis of single-arm studies (baseline to endpoint changes) limited to participants with MDD has supported the significant effect of tPBM in reducing the depression severity, without a significant heterogeneity (Hedges' g = 1.142, 95% confidence interval = 0.780-1.504, z = 6.19, p < 0.001, k = 5). However, the meta-analysis of the few double-blind, sham-controlled studies in MDD has not supported the statistically significant superiority of tPBM over sham (Hedges' g = 0.499, p = 0.211, k = 3), although a sample size bias is likely present. Conclusions: Overall, this meta-analysis provides weak support for the promising role of tPBM in the treatment of depressive symptoms. Dose finding studies to determine optimal tPBM parameters followed by larger, randomized, sham-controlled studies will be needed to fully demonstrate the antidepressant efficacy of tPBM.
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Affiliation(s)
- Yoonju Cho
- Division of Neuropsychiatry and Neuromodulation, Department of Psychiatry, Massachusetts General Hospital, Charlestown, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Umit Tural
- Nathan Kline Institute for Psychiatric Research, Orangeburg, New York, USA
| | - Dan V. Iosifescu
- Nathan Kline Institute for Psychiatric Research, Orangeburg, New York, USA
- Department of Psychiatry, New York University School of Medicine, New York, New York, USA
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3
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Tural U, Sparpana A, Sullivan E, Iosifescu DV. Comparison of Adiponectin Levels in Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder, Obesity, Constitutional Thinness, and Healthy Controls: A Network Meta-Analysis. Life (Basel) 2023; 13:life13051181. [PMID: 37240826 DOI: 10.3390/life13051181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/25/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
Adiponectin is a protein hormone that is produced and secreted primarily by adipose tissue. The levels of adiponectin in those with eating disorders, obesity, and healthy controls have been extensively studied. However, the general picture of the differences in adiponectin levels across the mentioned conditions is still unclear and fragmented. In this study, we pooled previous studies and performed a network meta-analysis to gain a global picture of comparisons of adiponectin levels across eating disorders, obesity, constitutional thinness, and healthy controls. Electronic databases were searched for anorexia nervosa, avoidant restrictive food intake disorder, binge-eating disorder, bulimia nervosa, healthy controls, night eating syndrome, obesity, and constitutional thinness in studies where adiponectin levels were measured. A total of 4262 participants from 50 published studies were included in the network meta-analysis. Adiponectin levels were significantly higher in participants with anorexia nervosa than in healthy controls (Hedges' g = 0.701, p < 0.001). However, adiponectin levels in constitutionally thin participants were not significantly different from those of healthy controls (Hedges' g = 0.470, p = 0.187). Obesity and binge-eating disorder were associated with significantly lower adiponectin levels compared to those of healthy controls (Hedges' g = -0.852, p < 0.001 and Hedges' g = -0.756, p = 0.024, respectively). The disorders characterized by excessive increases or decreases in BMI were associated with significant changes in adiponectin levels. These results suggest that adiponectin may be an important marker of severely disequilibrated homeostasis, especially in fat, glucose, and bone metabolisms. Nonetheless, an increase in adiponectin may not simply be associated with a decrease in BMI, as constitutional thinness is not associated with a significant increase in adiponectin.
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Affiliation(s)
- Umit Tural
- Clinical Research Division, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA
| | - Allison Sparpana
- Clinical Research Division, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA
- Psychiatry Department, New York University School of Medicine, New York, NY 10016, USA
| | - Elizabeth Sullivan
- Clinical Research Division, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA
- Psychiatry Department, New York University School of Medicine, New York, NY 10016, USA
| | - Dan V Iosifescu
- Clinical Research Division, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA
- Psychiatry Department, New York University School of Medicine, New York, NY 10016, USA
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4
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Hoptman MJ, Tural U, Arnold MS, Collins KA, Evans KT, Irvin MK, Parincu Z, Rette DN, Sparpana AM, Sullivan EF, Iosifescu DV. Suicidal ideation and behavior in schizophrenia: The role of negative urgency and psychiatric symptoms. Schizophr Res 2023; 254:173-175. [PMID: 36906943 DOI: 10.1016/j.schres.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/02/2023] [Accepted: 02/04/2023] [Indexed: 03/14/2023]
Affiliation(s)
- Matthew J Hoptman
- Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA.
| | - Umit Tural
- Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Molly S Arnold
- Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Katherine A Collins
- Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Kathryn T Evans
- Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Molly K Irvin
- Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
| | - Zamfira Parincu
- Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Danielle N Rette
- Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Allison M Sparpana
- Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
| | - Elizabeth F Sullivan
- Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
| | - Dan V Iosifescu
- Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Department of Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
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Mutluer T, Gorker I, Akdemir D, Ozdemir DF, Ozel OO, Vural P, Tufan AE, Karacetin G, Arman AR, Fis NP, Demirci E, Ozmen S, Hesapcioglu ST, Oztop D, Tural U, Aktepe E, Aksu H, Ardic UA, Basgul S, Bilac O, Coskun M, Celik GG, Demirkaya SK, Dursun OB, Durukan I, Fidan T, Gokcen C, Gormez V, Gundogdu OY, Herguner S, Kandemir H, Kilic BG, Kilincaslan A, Nasiroglu S, Sapmaz SY, Sahin N, Tahiroglu AY, Toros F, Unal F, Yazici IP, Yazici KU, Isik U, Ercan ES. Prevalence, comorbidities and mediators of childhood anxiety disorders in urban Turkey: a national representative epidemiological study. Soc Psychiatry Psychiatr Epidemiol 2022:10.1007/s00127-022-02396-7. [PMID: 36526939 PMCID: PMC9758023 DOI: 10.1007/s00127-022-02396-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE The aim of this study is to evaluate the prevalence of anxiety disorders, its correlation with sociodemographic characteristics, its comorbidities with other psychiatric disorders and its predictors in school-aged children. METHODS This study is part of a representative, multi-centered national study that is planned by the Turkish Association of Child and Adolescent Mental Health to evaluate the prevalence of psychopathology among elementary school students in Turkey between the years 2014-2015. Children are screened via Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version. Impairment is assessed by a 3-point Likert type scale independently by the parent and the teacher. The final sample included 5842 children with the mean age of 8.7 years. RESULTS The prevalence of any anxiety disorder without considering impairment is 16.7% and considering impairment is 5.2% in children according to our study. We found significant differences for comorbid Attention Deficit Hyperactivity Disorder, Disruptive Behavior Disorder, Mood Disorders, Tic Disorders, Obsessive Compulsive Disorder, Enuresis Nocturna, Encopresis, and Intellectual Disability. Having a history of paternal physical disorder, living in the regions of Marmara, Mediterranean and Black Sea were found to be the main predictors of having childhood anxiety disorders according to the logistic regression analysis. CONCLUSION Better understanding of childhood anxiety disorders, comorbid conditions and predictors will result in earlier diagnosis and more appropriate treatment.
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Affiliation(s)
- T. Mutluer
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Koç University School of Medicine, Istanbul, Turkey
| | - I. Gorker
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Trakya University, Edirne, Turkey
| | - D. Akdemir
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Hacettepe University, Ankara, Turkey
| | - D. Foto Ozdemir
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Hacettepe University, Ankara, Turkey
| | - O. Ozcan Ozel
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Inonu University, Malatya, Turkey
| | - P. Vural
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Uludag University, Bursa, Turkey
| | - A. E. Tufan
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Abant Izzet Baysal University, Bolu, Turkey
| | - G. Karacetin
- Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Research and Training Hospital for Psychiatric and Neurological Diseases, Istanbul, Turkey
| | - A. Rodopman Arman
- Department of Child and Adolescent Psychiatry, Marmara University, Pendik Training and Research Hospital, Istanbul, Turkey
| | - N. Perdahli Fis
- Department of Child and Adolescent Psychiatry, Marmara University, Pendik Training and Research Hospital, Istanbul, Turkey
| | - E. Demirci
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Erciyes University, Kayseri, Turkey
| | - S. Ozmen
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Erciyes University, Kayseri, Turkey
| | - S. Tural Hesapcioglu
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Karadeniz Technical University, Trabzon, Turkey
| | - D. Oztop
- Faculty of Medicine, Child and Adolescent Psychiatry Department, Ankara University, Ankara, Turkey
| | - U. Tural
- Faculty of Medicine, Department of Psychiatry, Kocaeli University, Kocaeli, Turkey
| | - E. Aktepe
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Suleyman Demirel University, Isparta, Turkey
| | - H. Aksu
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Adnan Menderes University, Aydin, Turkey
| | - U. Akyol Ardic
- Child and Adolescent Psychiatry, Denizli State Hospital, Denizli, Turkey
| | - S. Basgul
- Department of Psychology, Hasan Kalyoncu University, Istanbul, Turkey
| | - O. Bilac
- Department of Child and Adolescent Psychiatry, Manisa Celal Bayar University, Manisa, Turkey
| | - M. Coskun
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul University, Istanbul, Turkey
| | - G. G. Celik
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Cukurova University, Adana, Turkey
| | | | - O. B. Dursun
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ataturk University, Erzurum, Turkey
| | - I. Durukan
- Gulhane Faculty of Medicine, Department of Child and Adolescent Psychiatry, University of Health Sciences, Ankara, Turkey
| | - T. Fidan
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Osmangazi University, Eskisehir, Turkey
| | - C. Gokcen
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Gaziantep University, Gaziantep, Turkey
| | - V. Gormez
- Department of Child and Adolescent Psychiatry, Bezmi Alem University, Istanbul, Turkey
| | - O. Yildiz Gundogdu
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Kocaeli University, Kocaeli, Turkey
| | - S. Herguner
- Meram Faculty of Medicine, Department of Child and Adolescent Psychiatry, Necmettin Erbakan University, Konya, Turkey
| | - H. Kandemir
- Medical School, Department of Child and Adolescent Psychiatry, Harran University, Sanliurfa, Turkey
| | - B. Gunay Kilic
- Faculty of Medicine, Child and Adolescent Psychiatry Department, Ankara University, Ankara, Turkey
| | - A. Kilincaslan
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul University, Istanbul, Turkey
| | - S. Nasiroglu
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Akdeniz University, Antalya, Turkey
| | - S. Yalin Sapmaz
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Celal Bayar University, Manisa, Turkey
| | - N. Sahin
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Mugla Sitki Kocman University, Mugla, Turkey
| | - A. Y. Tahiroglu
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Cukurova University, Adana, Turkey
| | - F. Toros
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Mersin University, Mersin, Turkey
| | - F. Unal
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Hacettepe University, Ankara, Turkey
| | - I. Percinel Yazici
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Firat University, Elazig, Turkey
| | - K. U. Yazici
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Firat University, Elazig, Turkey
| | - U. Isik
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Suleyman Demirel University, Isparta, Turkey
| | - E. S. Ercan
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ege University, Izmir, Turkey
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Tural U, Iosifescu DV. Adiponectin in anorexia nervosa and its modifiers: A meta-regression study. Int J Eat Disord 2022; 55:1279-1290. [PMID: 35689560 DOI: 10.1002/eat.23753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Adiponectin, which is secreted from adipose tissue, is a protein hormone. Although a large body of studies have found that circulating adiponectin levels increase in anorexia nervosa (AN) and caloric restriction, the effect of subtypes of AN and modifiers of adiponectin in AN are not yet known. METHODS A systematic search of electronic databases was performed using the search terms "adiponectin," "anorexia nervosa," and "eating disorder" up to January 2021. All studies published in peer-reviewed journals, which included cases and control groups, were selected. The main outcome was the pooled standardized mean difference (SMD) in adiponectin levels between cases and controls, using the random-effects model. Modifiers of SMD were tested via meta-regression. Heterogeneity and publication bias were evaluated. RESULTS Thirty-four studies met all eligibility criteria. The total sample of AN participants (Hedges' g = .765, p < .0001), and specifically the binge-eating/purging (Hedges' g = 1.211, p < .00001) and restrictive subtypes (Hedges' g = .913, p < .00001) of AN have increased adiponectin plasma levels compared with healthy controls. Meta-regression determined that insulin, IGF-1, BMI, triglyceride, resistin, glucose, IL-6 levels are significant modifiers of adiponectin levels. DISCUSSION Compared with controls, adiponectin levels are higher in AN overall, and specifically in the binge-eating/purging and the restrictive AN subtypes. Many of metabolic parameters of glucose metabolism and pro-inflammatory molecules modify the relationship between AN and adiponectin levels. Adipose tissue is important to maintain metabolic stability. PUBLIC SIGNIFICANCE Anorexia nervosa is a psychiatric disorder associated with a severe decrease in body weight and multiple metabolic abnormalities, including an increase in the hormone adiponectin. In this paper, we used meta-analysis, a powerful statistical method, to aggregate data from 34 rigorously selected research reports. This enabled us to understand the value of adiponectin to differentiate clinical subtypes of anorexia nervosa and the relations between adiponectin and other important metabolic parameters.
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Affiliation(s)
- Umit Tural
- Clinical Research Division, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York, USA
| | - Dan V Iosifescu
- Clinical Research Division, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York, USA.,Psychiatry Department, New York University School of Medicine, New York, New York, USA
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7
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Iosifescu DV, Norton RJ, Tural U, Mischoulon D, Collins K, McDonald E, De Taboada L, Foster S, Cusin C, Yeung A, Clain A, Schoenfeld D, Hamblin MR, Cassano P. Very Low-Level Transcranial Photobiomodulation for Major Depressive Disorder: The ELATED-3 Multicenter, Randomized, Sham-Controlled Trial. J Clin Psychiatry 2022; 83. [PMID: 35950904 DOI: 10.4088/jcp.21m14226] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Background: Transcranial photobiomodulation (t-PBM) with near-infrared (NIR) light might represent a treatment for major depressive disorder (MDD). However, the dosimetry of administered t-PBM varies widely. We tested the efficacy of t-PBM with low irradiance, low energy per session, and low number of sessions in individuals with MDD. Methods: A 2-site, double-blind, sham-controlled study was conducted of adjunct t-PBM NIR (830 nm; continuous wave; 35.8 cm2 treatment area; 54.8 mW/cm2 irradiance; 65.8 J/cm2 fluence, 20 min/session; ~2 W total power; 2.3 kJ total energy per session), delivered to the prefrontal cortex, bilaterally, twice a week for 6 weeks, in subjects diagnosed with MDD per the DSM-IV criteria. Subjects were recruited between August 2016 and May 2018. A sequential parallel comparison design was used: 18 nonresponders to sham in phase 1 (6 weeks) were re-randomized in phase 2. The primary outcome was reduction in depression severity (Hamilton Depression Rating Scale [HDRS-17] and Quick Inventory of Depressive Symptomatology-Clinician Rating [QIDS-C] scores) from baseline. Statistical analyses used R package SPCDAnalyze2, including all subjects with ≥ 1 post-randomization evaluation. Results: Of the 54 subjects recruited, we included 49 MDD subjects in the analysis (71% female, mean ± SD age 40.8 ± 16.1 years). There were no significant differences between t-PBM and sham with respect to the change in HDRS-17 (t = -0.319, P = .751) or QIDS-C (t = -0.499, P = .620) scores. The sham effect was reasonably low. Conclusions: Mostly uncontrolled studies suggest the efficacy of t-PBM for MDD; however, its optimal dose is still to be defined. A minimal dose threshold is likely necessary, similarly to other neuromodulation techniques in MDD (electroconvulsive therapy, transcranial magnetic stimulation). We established a threshold of inefficacy of t-PBM for MDD, based on combined low irradiance, low energy per session, and low number of sessions. Trial Registration: ClinicalTrials.gov identifier: NCT02959307.
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Affiliation(s)
- Dan V Iosifescu
- Clinical Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, New York.,Department of Psychiatry, New York University School of Medicine, New York, New York.,Corresponding author: Dan V. Iosifescu, MD, MSc, Nathan Kline Institute, 140 Old Orangeburg Rd, Orangeburg, NY 10962
| | - Richard J Norton
- Department of Psychological Science, University of Vermont, Burlington, Vermont
| | - Umit Tural
- Clinical Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, New York
| | - David Mischoulon
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Katherine Collins
- Clinical Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, New York
| | - Erin McDonald
- Clinical Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, New York
| | | | - Simmie Foster
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Cristina Cusin
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Albert Yeung
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Alisabet Clain
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - David Schoenfeld
- Biostatistics Center, Massachusetts General Hospital, Boston, Massachusetts.,Department of Public Health, Harvard Medical School, Boston, Massachusetts
| | - Michael R Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Johannesburg, South Africa
| | - Paolo Cassano
- Depression Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.,Division of Neuropsychiatry, Massachusetts General Hospital, Boston, Massachusetts
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8
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Krakowski MI, Tural U, Czobor P. Separate pathways to violent behavior in schizophrenia and in the general population. J Psychiatr Res 2022; 151:235-241. [PMID: 35500451 DOI: 10.1016/j.jpsychires.2022.04.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 04/05/2022] [Accepted: 04/18/2022] [Indexed: 10/18/2022]
Abstract
Violence in schizophrenia is best investigated within the broader context of violent behavior in the general population. Two important domains of general pathology which allow us to take such an approach include impairment in emotion processing, as manifested by faulty facial emotion recognition, and aggressive reactivity which consists of heightened sensitivity to provocation. To test this approach, we included 135 subjects: 38 violent (VS's) and 33 nonviolent patients with schizophrenia, 32 healthy controls and 32 non-psychotic violent subjects (NPV's). We measured violence with the Life History of Aggression Scale, recognition of facial emotions with the Emotion Recognition Task, and aggressive reactivity through the Buss-Perry Aggression Questionnaire. Adolescent antisocial behavior was evaluated as a potential precursor to these deficits. We found that impairment in fear recognition (IFR) and aggressive reactivity have a significant effect on violence in the violent groups. These two impairments interact in different ways in these groups. In NPV's they contribute in an additive fashion to violence, whereas in VS's they represent separate pathways; aggressive reactivity leads to violence only when there is no IFR. Adolescent antisocial behavior has a differential effect on these 2 impairments in the 2 groups. Thus, these findings provide insights on the differential role of IFR and aggressive reactivity for violence in schizophrenia compared to the general population. In NPV's, both dysfunctions represent antisocial features and contribute jointly to violence. In schizophrenia, they have different etiologies and constitute alternative pathways to violence. This has important implications for the conceptualization and treatment of violence.
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Affiliation(s)
- Menahem I Krakowski
- The Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd, Orangeburg, NY, 10962, USA; New York University School of Medicine, Department of Psychiatry, 550 First Avenue, New York, NY, USA.
| | - Umit Tural
- The Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd, Orangeburg, NY, 10962, USA.
| | - Pal Czobor
- Departments of Psychiatry and Psychotherapy, Semmelweis University Budapest, Hungary Dept. of Psychiatry and Psychotherapy, Semmelweis University. Balassa Str. 6. 1083 Budapest, Hungary.
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9
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Abstract
BACKGROUND Previous studies have demonstrated elevated levels of the S100B protein (located in glial cells) in major depressive disorder (MDD) as compared to healthy controls. However, studies reporting correlation between S100B levels and depression severity have been conflicting. METHODS We investigated, through systematic review and meta-analysis, whether the correlation between S100B levels and depression severity is significant in patients with MDD. Pearson correlation coefficients reported in the individual studies were converted to Fisher's Z scores, then pooled using the random effects model. Meta-regression was used to test modifiers of the effect size. RESULTS Sixteen studies including 658 patients with MDD met eligibility criteria. No publication bias was observed. There was a significant and positive correlation between serum S100B level and depression severity (r = 0.204, z = 2.297, p = 0.022). A meta-regression determined that onset age of MDD and percentage of female participants are significant modifiers of this correlation. A moderate, but non-significant heterogeneity was observed in serum studies (44%). CONCLUSION As many studies have reported significantly increased levels of S100B in MDD compared to controls, this meta-analysis supports the assumption that the increase in S100B correlates with the severity of MDD. Additional studies investigating the precise biological connection between S100B and MDD are indicated.
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Affiliation(s)
- Umit Tural
- Clinical Research Division, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Molly Kennedy Irvin
- Clinical Research Division, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Dan Vlad Iosifescu
- Clinical Research Division, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA.,Psychiatry Department, New York University School of Medicine, New York, NY, USA
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10
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Ercan ES, Unsel-Bolat G, Tufan AE, Karakoc Demirkaya S, Bilac O, Celik G, Kılıç BG, Akyol Ardic U, Yalin Sapmaz S, Aksu H, Yolga Tahiroglu A, Karacetin G, Tural U, Aktepe E, Rodopman Arman A, Başgül S, Coşkun M, Dursun OB, Durukan İ, Perdahli Fiş N, Gençoğlan S, Gökçen C, Sarı Gokten E, Görker I, Görmez V, Yıldız Gündoğdu Ö, Hesapçioğlu ST, Kandemir H, Mutluer T, Nasiroğlu S, Özcan Ö, Şahin N, Toros F, Perçinel Yazici İ, Yazici KU, Yulaf Y, Yüksel T, Bilgic A, Altun H, Akdemir D, Mazlum B, Çakın Memik N, Foto Özdemir D, Üneri Ö, Ünal F. Effect of Impairment on the Prevalence and Comorbidities of Attention Deficit Hyperactivity Disorder in a National Survey: Nation-Wide Prevalence and Comorbidities of ADHD. J Atten Disord 2022; 26:674-684. [PMID: 34032170 DOI: 10.1177/10870547211017985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study aimed to determine the prevalence and comorbidities of attention-deficit hyperactivity disorder (ADHD) by evaluating a large-scale nation-wide sample of children. METHOD The inclusion criterion was being enrolled as a 2nd, 3rd, or 4th-grade student. A semi-structured diagnostic interview (K-SADS-PL), DSM-IV-Based Screening Scale for Disruptive Behavior Disorders, and assessment of impairment (by both parents and teachers) were applied to 5,842 participants. RESULTS The prevalence of ADHD was 19.5% without impairment and 12.4% with impairment. Both ADHD with and without impairment groups had similar psychiatric comorbidity rates except for oppositional defiant disorder (ODD) and conduct disorder (CD) diagnoses. Impairment in the ADHD group resulted in significantly higher ODD and CD diagnoses. CONCLUSION Even when impairment is not described, other psychiatric disorders accompany the diagnosis of ADHD and may cause impairment in the future. Impairment in the diagnosis of ADHD significantly increases the likelihood of ODD and CD.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Gul Karacetin
- Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Mental Health and Nervous Disorders, Istanbul, Turkey
| | - Umit Tural
- Nathan S. Kline Institute, New York, USA
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11
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Hoptman MJ, Tural U, Lim KO, Javitt DC, Oberlin LE. Relationships between Diffusion Tensor Imaging and Resting State Functional Connectivity in Patients with Schizophrenia and Healthy Controls: A Preliminary Study. Brain Sci 2022; 12:brainsci12020156. [PMID: 35203920 PMCID: PMC8870342 DOI: 10.3390/brainsci12020156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/02/2022] [Accepted: 01/19/2022] [Indexed: 11/16/2022] Open
Abstract
Schizophrenia is widely seen as a disorder of dysconnectivity. Neuroimaging studies have examined both structural and functional connectivity in the disorder, but these modalities have rarely been integrated directly. We scanned 29 patients with schizophrenia and 25 healthy control subjects, and we acquired resting state fMRI and diffusion tensor imaging. We used the Functional and Tractographic Connectivity Analysis Toolbox (FATCAT) to estimate functional and structural connectivity of the default mode network. Correlations between modalities were investigated, and multimodal connectivity scores (MCS) were created using principal component analysis. Of the 28 possible region pairs, 9 showed consistent (>80%) tracts across participants. Correlations between modalities were found among those with schizophrenia for the prefrontal cortex, posterior cingulate, and lateral temporal lobes, with frontal and parietal regions, consistent with frontotemporoparietal network involvement in the disorder. In patients, MCS correlated with several aspects of the Positive and Negative Syndrome Scale, with higher multimodal connectivity associated with outward-directed (externalizing) behavior and lower multimodal connectivity related to psychosis per se. In this preliminary sample, we found FATCAT to be a useful toolbox to directly integrate and examine connectivity between imaging modalities. A consideration of conjoint structural and functional connectivity can provide important information about the network mechanisms of schizophrenia.
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Affiliation(s)
- Matthew J. Hoptman
- Clinical Research Division, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA;
- Department of Psychiatry, New York University Grossman School of Medicine, New York, NY 10016, USA
- Correspondence: or ; Tel.: +1-845-398-6569
| | - Umit Tural
- Clinical Research Division, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA;
| | - Kelvin O. Lim
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55454, USA;
| | - Daniel C. Javitt
- Schizophrenia Research Division, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA; or
- Division of Experimental Therapeutics, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
| | - Lauren E. Oberlin
- Department of Psychiatry, Weill Cornell Medicine, New York, NY 10065, USA;
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12
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Tural U, Iosifescu DV. A systematic review and network meta-analysis of carbon dioxide provocation in psychiatric disorders. J Psychiatr Res 2021; 143:508-515. [PMID: 33250190 DOI: 10.1016/j.jpsychires.2020.11.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/09/2020] [Accepted: 11/15/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND False suffocation alarm hypothesis has been widely used to explain carbon dioxide hypersensitivity in panic disorder (PD). However, hypersensitivity to carbon dioxide has been observed in other psychiatric disorders. We explored the specificity of carbon dioxide inhalation as a panic provocation test among psychiatric disorders via network meta-analysis. METHODS A systematic literature search on PubMed, EMBASE, and PsycNET was performed to acquire the studies using the carbon dioxide provocation test in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and checklists. Odds ratios (OR) for a panic attack (PA) induced by the carbon dioxide inhalation tests were extracted from each of the original studies and were pooled using the random-effects model. RESULTS Network meta-analysis on a pool of 2181 participants from 41 studies was used to compare the efficacy of carbon dioxide provocation tests among psychiatric disorders. The network meta-analysis showed that the odds for PA in response to carbon dioxide inhalation are higher in patients with PD, premenstrual dysphoric syndrome (PMDD), and social anxiety disorder (SAD) than healthy controls (HC). The odds for PA were not significantly different among patients with generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), major depressive disorder (MDD), and healthy controls (HC). CONCLUSIONS The vulnerability to the carbon dioxide provocation test is not limited to PD. The specificity of the test for PD is questionable, as individuals suffering from PMDD and SAD are also significantly more responsive to carbon dioxide inhalation compared to HC, OCD, MDD, and GAD. There may be shared underpinning biological mechanisms between PD, PMDD, and SAD.
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Affiliation(s)
- Umit Tural
- Clinical Research Division, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA.
| | - Dan V Iosifescu
- Clinical Research Division, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA; Psychiatry Department, New York University School of Medicine, New York, NY 10016, USA
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13
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Tural U, Iosifescu DV. Comparison of Sodium Lactate Infusion and Carbon Dioxide Inhalation Panic Provocation Tests: A Meta-analysis. Pharmacopsychiatry 2021; 55:87-94. [PMID: 34666404 DOI: 10.1055/a-1589-6049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Sodium lactate (NaL) infusion and carbon dioxide (CO2) inhalation are proven to provoke acute panic attacks (PAs) in patients with panic disorder (PD). A systematic literature search and meta-analysis were performed to compare the effect sizes of these methods. METHODS Odds ratios were calculated for each of the original studies and were pooled using the random-effects model. RESULTS Either NaL or CO2 provocations significantly increased the rates of PAs in individuals with PD compared to those in healthy controls. However, the effect size of NaL infusion (OR=25.13, 95% CI=15.48-40.80) was significantly greater than that of CO2 inhalation (OR=10.58, 95%CI=7.88-14.21). CONCLUSION The evidence for the efficacy of the two panic provocation tests is very strong. Yet, the results support the superiority of NaL infusion over CO2 inhalation challenge as a panic provocation test. Thus, lactate seems a much stronger stimulus than CO2 for the brain suffocation detector.
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Affiliation(s)
- Umit Tural
- Clinical Research Division, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, USA
| | - Dan V Iosifescu
- Clinical Research Division, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, USA.,Psychiatry Department, New York University School of Medicine, New York, USA
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14
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Krakowski M, Tural U, Czobor P. The Importance of Conduct Disorder in the Treatment of Violence in Schizophrenia: Efficacy of Clozapine Compared With Olanzapine and Haloperidol. Am J Psychiatry 2021; 178:266-274. [PMID: 33472389 DOI: 10.1176/appi.ajp.2020.20010052] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Treatment of violence in schizophrenia remains a challenging problem, especially in patients with conduct disorder. Previous clinical studies did not select patients on the basis of violence and did not focus on conduct disorder. This study is a head-to-head comparison of clozapine, olanzapine, and haloperidol in the treatment of violent schizophrenia patients with and without conduct disorder. METHODS Physically assaultive schizophrenia patients (N=99) were randomly assigned to receive clozapine, olanzapine, or haloperidol in a 12-week double-blind trial. They were characterized on the basis of the presence or absence of conduct disorder before age 15. Assaults were recorded; their frequency and severity were scored on the Modified Overt Aggression Scale. Psychiatric symptoms were evaluated through the Positive and Negative Syndrome Scale. RESULTS Patients with a history of conduct disorder had more frequent and severe assaults than those without conduct disorder during the 12-week trial. Clozapine was superior to haloperidol and olanzapine in reducing assaults; olanzapine was superior to haloperidol. Clozapine's greater antiaggressive efficacy over haloperidol was substantially more pronounced in patients with conduct disorder than in patients without conduct disorder. In patients with conduct disorder, clozapine was four times more likely than haloperidol to result in lower violence; in patients without conduct disorder, it was three times more likely to do so. Olanzapine's superiority over haloperidol was also more pronounced in patients with conduct disorder. CONCLUSIONS This study is the first to examine the effect of clozapine in violent schizophrenia patients with conduct disorder. When conduct disorder is present, clozapine is the optimal treatment.
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Affiliation(s)
- Menahem Krakowski
- Department of Psychiatry, Nathan Kline Institute for Psychiatric Research, Orangeburg, N.Y. (Krakowski, Tural); Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest (Czobor)
| | - Umit Tural
- Department of Psychiatry, Nathan Kline Institute for Psychiatric Research, Orangeburg, N.Y. (Krakowski, Tural); Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest (Czobor)
| | - Pál Czobor
- Department of Psychiatry, Nathan Kline Institute for Psychiatric Research, Orangeburg, N.Y. (Krakowski, Tural); Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest (Czobor)
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15
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Onder E, Tural U, Aker T. A comparative study of fluoxetine, moclobemide, and tianeptine in the treatment of posttraumatic stress disorder following an earthquake. Eur Psychiatry 2020; 21:174-9. [PMID: 15964747 DOI: 10.1016/j.eurpsy.2005.03.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2003] [Accepted: 03/24/2005] [Indexed: 12/31/2022] Open
Abstract
Abstract.PurposeAlthough antidepressant drugs have been proven as an effective treatment for posttraumatic stress disorder (PTSD), there are few comparative studies of antidepressants that are acting on different neurotransmitters. The main aim of this study is to compare the efficacy of different class of antidepressant drugs on the PTSD.Subjects/materials and methods. –In this open label study, the patients who met DSM-IV criteria for PTSD were randomly assigned to flexible doses of fluoxetine, moclobemide, or tianeptine. After the first assessment, consecutive assessments were performed at the end of weeks 2, 4, 8, and 12 using clinician administered PTSD scale (CAPS) and Clinical Global Impression of Severity (CGI-S). Changes in the total score of CAPS and sub-scale scores of symptom clusters (re-experience, avoidance, and hyperarousal) were the main output of efficacy. All statistics were based on intention-to-treat and last-observation-carried-forward (LOCF) principles.Results.Thirty-eight patients were assigned to fluoxetine, 35 patients were assigned to moclobemide, and 30 patients were assigned to tianeptine group. Gender distributions and mean ages of the treatment groups were not significantly different. Drop-out rates due to an adverse events or unknown reasons were not significantly different among fluoxetine (18.4%), moclobemide (14.3%), and tianeptine (20.0%) groups. All three treatments has led to a significant improvement in PTSD severity assessed with CAPS total score (ANOVA P < 0.001). Similarly, total scores of re-experiencing, avoidance, and hyperarousal clusters that are subscales of CAPS were significantly reduced by all three treatments (with ANOVA all P values < 0.001). There was not significant difference in terms of treatment effect between three groups.Discussion. –Treatment groups showed very similar improvement on all ratings scales. The findings support that fluoxetine, moclobemide, and tianeptine are all effective in the treatment of PTSD. Different mechanisms of action for these antidepressant drugs might result in the same common neurochemical end point. However, further studies using different classes of antidepressant drugs are needed.
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Affiliation(s)
- E Onder
- Center for Psychological Trauma, Medical School of Kocaeli University, Kocaeli, Turkey
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16
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Tural U, Iosifescu DV. Neuropeptide Y in PTSD, MDD, and chronic stress: A systematic review and meta-analysis. J Neurosci Res 2020; 98:950-963. [PMID: 32048334 DOI: 10.1002/jnr.24589] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/14/2020] [Accepted: 01/22/2020] [Indexed: 01/23/2023]
Abstract
Previous studies have suggested that neuropeptide Y (NPY) levels may be altered in patients with major depressive disorder (MDD), post-traumatic stress disorder (PTSD) and chronic stress. We investigated, through systematic review and meta-analysis, whether the mean levels of NPY are significantly different in patients with MDD, PTSD or chronic stress, compared to controls. The main outcome was the pooled standardized mean difference (SMD) with 95% confidence intervals between cases and controls, using the random-effects model. Heterogeneity and publication bias were evaluated. Thirty-five studies met eligibility criteria. Meta-regression determined that medication and sex could explain 27% of the between-study variance. Females and participants currently prescribed psychotropic medications had significantly higher levels of NPY. NPY levels were significantly lower in plasma and cerebrospinal fluid (CSF) in PTSD patients versus controls. Patients with MDD had significantly lower levels of NPY in plasma compared to controls, but not in the CSF. The magnitudes of the decrease in plasma NPY levels were not significantly different between PTSD and MDD. However, chronic stress patients had significantly higher plasma NPY levels compared to controls, PTSD or MDD. Our findings may imply a shared role of NPY in trauma and depression: nevertheless, it is not clear that the association is specific to these disorders. Psychotropic medications may help restore NPY levels. Further controlled studies are needed to better delineate the contribution of confounding variables such as type of depression, body mass index, appetite or sleep architecture.
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Affiliation(s)
- Umit Tural
- Clinical Research Division, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Dan V Iosifescu
- Clinical Research Division, The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA.,Psychiatry Department, New York University School of Medicine, New York, NY, USA
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17
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Ercan ES, Polanczyk G, Akyol Ardıc U, Yuce D, Karacetın G, Tufan AE, Tural U, Aksu H, Aktepe E, Rodopman Arman A, Başgül S, Bılac O, Coşkun M, Celık GG, Karakoc Demırkaya S, Dursun BO, Durukan İ, Fidan T, Perdahlı Fiş N, Gençoğlan S, Gökçen C, Görker I, Görmez V, Gündoğdu ÖY, Gürkan CK, Hergüner S, Tural Hesapçıoğlu S, Kandemir H, Kılıç BG, Kılınçaslan A, Mutluer T, Nasiroğlu S, Özel Özcan Ö, Öztürk M, Öztop D, Yalın Sapmaz S, Süren S, Şahin N, Yolga Tahıroglu A, Toros F, Ünal F, Vural P, Perçinel Yazıcı İ, Yazıcı KU, Yıldırım V, Yulaf Y, Yüce M, Yüksel T, Akdemir D, Altun H, Ayık B, Bilgic A, Hekim Bozkurt Ö, Demirbaş Çakır E, Çeri V, Üçok Demir N, Dinç G, Irmak MY, Karaman D, Kınık MF, Mazlum B, Memik NÇ, Foto Özdemir D, Sınır H, Ince Taşdelen B, Taşkın B, Uğur Ç, Uran P, Uysal T, Üneri Ö, Yilmaz S, Seval Yılmaz S, Açıkel B, Aktaş H, Alaca R, Alıç BG, Almaidan M, Arı FP, Aslan C, Atabay E, Ay MG, Aydemir H, Ayrancı G, Babadagı Z, Bayar H, Çon Bayhan P, Bayram Ö, Dikmeer Bektaş N, Berberoğlu KK, Bostan R, Arıcı Canlı M, Cansız MA, Ceylan C, Coşkun N, Coşkun S, Çakan Y, Demir İ, Demir N, Yıldırım Demirdöğen E, Doğan B, Dönmez YE, Dönder F, Efe A, Eray Ş, Erbilgin S, Erden S, Ersoy EG, Eseroğlu T, Kına Fırat S, Eynallı Gök E, Güler G, Güles Z, Güneş S, Güneş A, Günay G, Gürbüz Özgür B, Güven G, Çelik Göksoy Ş, Horozcu H, Irmak A, Işık Ü, Kahraman Ö, Kalaycı BM, Karaaslan U, Karadağ M, Kılıc HT, Kılıçaslan F, Kınay D, Kocael Ö, Bulanık Koç E, Kadir Mutlu R, Lushi-Şan Z, Nalbant K, Okumus N, Özbek F, Akkuş Özdemir F, Özdemir H, Özkan S, Yıldırım Özyurt E, Polat B, Polat H, Sekmen E, Sertçelik M, Sevgen FH, Sevince O, Süleyman F, Shamkhalova Ü, Eren Şimşek N, Tanır Y, Tekden M, Temtek S, Topal M, Topal Z, Türk T, Uçar HN, Uçar F, Uygun D, Uzun N, Vatansever Z, Yazgılı NG, Miniksar Yıldız D, Yıldız N. The prevalence of childhood psychopathology in Turkey: a cross-sectional multicenter nationwide study (EPICPAT-T). Nord J Psychiatry 2019; 73:132-140. [PMID: 30964388 DOI: 10.1080/08039488.2019.1574892] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIM The aim of this study was to determine the prevalence of childhood psychopathologies in Turkey. METHOD A nation-wide, randomly selected, representative population of 5830 children (6-13 years-old) enrolled as a 2nd,3rd or 4th grade student in 30 cities were evaluated for presence of a psychiatric or mental disorder by a Sociodemographic Form, Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL), and DSM-IV-Based Screening Scale for Disruptive Behavior Disorders in Children and Adolescents scales. Impairment criterion was assessed via a 3 point-Likert scale by the parent and the teacher independently. RESULTS Overall prevalence of any psychopathology was 37.6% without impairment criterion, and 17.1% with impairment criterion. Attention-deficit hyperactivity disorder was the most frequent diagnosis, followed by anxiety (19.5% and 16.7% without impairment, 12.4% and 5.3% with impairment, respectively). Lower education level and presence of a physical or psychiatric problem of the parents were independent predictors of any psychopathology of the offspring. CONCLUSION This is the largest and most comprehensive epidemiological study to determine the prevalence of psychopathologies in children and adolescents in Turkey. Our results partly higher than, and partly comparable to previous national and international studies. It also contributes to the literature by determining the independent predictors of psychopathologies in this age group.
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Affiliation(s)
- Eyup Sabri Ercan
- a Child and Adolescent Psychiatry Department, Medical Faculty , Ege University , Izmir , Turkey
| | - Guilherme Polanczyk
- b Department of Psychiatry , University of Sao Paulo Medical School , São Paulo , BR
| | - Ulku Akyol Ardıc
- c Child and Adolescent Psychiatry Department , Denizli State Hospital , Denizli , Turkey
| | - Deniz Yuce
- d Department of Preventive Oncology and Epidemiology , Cancer Institute, Hacettepe University , Ankara , Turkey
| | - Gul Karacetın
- e Child and Adolescent Psychiatry Department, Medical Faculty , Bakirkoy Prof. Dr. Mazhar OSMAN Training and Research Hospital for Mental Health and Nervous Disorders , Istanbul , Turkey
| | - Ali Evren Tufan
- f Child and Adolescent Psychiatry Department, Medical Faculty , Acıbadem University , Istanbul , Turkey
| | - Umit Tural
- g Psychiatry Department, Medical Faculty , Kocaeli University , Izmit , Turkey
| | - Hatice Aksu
- h Child and Adolescent Psychiatry Department, Medical Faculty , Adnan Menderes University , Aydın , Turkey
| | - Evrim Aktepe
- i Child and Adolescent Psychiatry Department, Medical Faculty , Suleyman Demirel University , Isparta , Turkey
| | - Ayşe Rodopman Arman
- j Child and Adolescent Psychiatry Department, Medical Faculty , Marmara University , Istanbul , Turkey
| | - Senem Başgül
- k Child and Adolescent Psychiatry Department, Medical Faculty , Private Clinic , Istanbul , Turkey
| | - Oznur Bılac
- l Child and Adolescent Psychiatry Department, Medical Faculty , Manisa Hospital for Mental Health and Nervous Disorders , Manisa , Turkey
| | - Murat Coşkun
- m Child and Adolescent Psychiatry Department, Medical Faculty , Istanbul University , Istanbul , Turkey
| | - Gonca Gul Celık
- n Child and Adolescent Psychiatry Department, Medical Faculty , Çukurova University , Adana , Turkey
| | - Sevcan Karakoc Demırkaya
- h Child and Adolescent Psychiatry Department, Medical Faculty , Adnan Menderes University , Aydın , Turkey
| | - Burak Onur Dursun
- o Child and Adolescent Psychiatry Department, Medical Faculty , Ataturk University , Erzurum , Turkey
| | - İbrahim Durukan
- p Child and Adolescent Psychiatry Department, Medical Faculty , Gülhane Training and Research Hospital , Ankara , Turkey
| | - Tülin Fidan
- q Child and Adolescent Psychiatry Department, Medical Faculty , Osmangazi University , Eskişehir , Turkey
| | - Neşe Perdahlı Fiş
- j Child and Adolescent Psychiatry Department, Medical Faculty , Marmara University , Istanbul , Turkey
| | - Salih Gençoğlan
- r Child and Adolescent Psychiatry Department, Medical Faculty , Private Clinic , Van , Turkey
| | - Cem Gökçen
- s Child and Adolescent Psychiatry Department, Medical Faculty , Gaziantep University , Gaziantep , Turkey
| | - Işık Görker
- t Child and Adolescent Psychiatry Department, Medical Faculty , Trakya University , Edirne , Turkey
| | - Vahdet Görmez
- u Child and Adolescent Psychiatry Department, Medical Faculty , Bezmi-alem University , Istanbul , Turkey
| | - Özlem Yıldız Gündoğdu
- v Child and Adolescent Psychiatry Department, Medical Faculty , Kocaeli University , Kocaeli , Turkey
| | - Cihat Kaan Gürkan
- w Child and Adolescent Psychiatry Department, Medical Faculty , Ankara University , Ankara , Turkey
| | - Sabri Hergüner
- x Child and Adolescent Psychiatry Department, Medical Faculty , Necmettin Erbakan University , Konya , Turkey
| | - Selma Tural Hesapçıoğlu
- y Child and Adolescent Psychiatry Department, Medical Faculty , Karadeniz Technical University , Trabzon , Turkey
| | - Hasan Kandemir
- z Child and Adolescent Psychiatry Department, Medical Faculty , Harran University , Sanlıurfa , Turkey
| | - Birim Günay Kılıç
- w Child and Adolescent Psychiatry Department, Medical Faculty , Ankara University , Ankara , Turkey
| | - Ayse Kılınçaslan
- m Child and Adolescent Psychiatry Department, Medical Faculty , Istanbul University , Istanbul , Turkey
| | - Tuba Mutluer
- r Child and Adolescent Psychiatry Department, Medical Faculty , Private Clinic , Van , Turkey
| | - Serhat Nasiroğlu
- aa Child and Adolescent Psychiatry Department, Medical Faculty , Sakarya University , Sakarya , Turkey
| | - Özlem Özel Özcan
- ab Child and Adolescent Psychiatry Department, Medical Faculty , Inonu University , Malatya , Turkey
| | - Mücahit Öztürk
- k Child and Adolescent Psychiatry Department, Medical Faculty , Private Clinic , Istanbul , Turkey
| | - Didem Öztop
- ac Child and Adolescent Psychiatry Department, Medical Faculty , Erciyes University , Kayseri , Turkey
| | - Sermin Yalın Sapmaz
- ad Child and Adolescent Psychiatry Department, Medical Faculty , Celal Bayar University , Manisa , Turkey
| | - Serkan Süren
- ae Child and Adolescent Psychiatry Department, Medical Faculty , 19 May University, Samsun , Turkey
| | - Nilfer Şahin
- af Child and Adolescent Psychiatry Department, Medical Faculty , Muğla Sıtkı Koçman University , Muğla , Turkey
| | - Aysegul Yolga Tahıroglu
- n Child and Adolescent Psychiatry Department, Medical Faculty , Çukurova University , Adana , Turkey
| | - Fevziye Toros
- ag Child and Adolescent Psychiatry Department, Medical Faculty , Mersin University , Mersin , Turkey
| | - Fatih Ünal
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Pınar Vural
- ai Child and Adolescent Psychiatry Department, Medical Faculty , Uludağ University , Bursa , Turkey
| | - İpek Perçinel Yazıcı
- aj Child and Adolescent Psychiatry Department, Medical Faculty , Fırat University , Elazığ , Turkey
| | - Kemal Utku Yazıcı
- aj Child and Adolescent Psychiatry Department, Medical Faculty , Fırat University , Elazığ , Turkey
| | - Veli Yıldırım
- ag Child and Adolescent Psychiatry Department, Medical Faculty , Mersin University , Mersin , Turkey
| | - Yasemin Yulaf
- ak Child and Adolescent Psychiatry Department, Medical Faculty , Private Clinic , Tekirdağ , Turkey
| | - Murat Yüce
- ae Child and Adolescent Psychiatry Department, Medical Faculty , 19 May University, Samsun , Turkey
| | - Tuğba Yüksel
- al Child and Adolescent Psychiatry Department, Medical Faculty , Dıcle University , Diyarbakır , Turkey
| | - Devrim Akdemir
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Hatice Altun
- am Child and Adolescent Psychiatry Department, Medical Faculty , Kahramanmaras Sutcu Imam University , Kahramanmaraş , Turkey
| | - Başak Ayık
- an Child and Adolescent Psychiatry Department, Medical Faculty , Usküdar University , İstanbul , Turkey
| | - Ayhan Bilgic
- x Child and Adolescent Psychiatry Department, Medical Faculty , Necmettin Erbakan University , Konya , Turkey
| | - Özlem Hekim Bozkurt
- ao Child and Adolescent Psychiatry Department, Medical Faculty , Ankara Hematology and Oncology Child Health and Diseases Training and Research Hospital , Ankara , Turkey
| | - Emine Demirbaş Çakır
- ap Child and Adolescent Psychiatry Department, Medical Faculty , Abant Izzet Baysal University , Bolu , Turkey
| | - Veysi Çeri
- j Child and Adolescent Psychiatry Department, Medical Faculty , Marmara University , Istanbul , Turkey
| | - Nagehan Üçok Demir
- j Child and Adolescent Psychiatry Department, Medical Faculty , Marmara University , Istanbul , Turkey
| | - Gülser Dinç
- ao Child and Adolescent Psychiatry Department, Medical Faculty , Ankara Hematology and Oncology Child Health and Diseases Training and Research Hospital , Ankara , Turkey
| | - Mustafa Yasin Irmak
- j Child and Adolescent Psychiatry Department, Medical Faculty , Marmara University , Istanbul , Turkey
| | - Dursun Karaman
- p Child and Adolescent Psychiatry Department, Medical Faculty , Gülhane Training and Research Hospital , Ankara , Turkey
| | - Mehmet Fatih Kınık
- v Child and Adolescent Psychiatry Department, Medical Faculty , Kocaeli University , Kocaeli , Turkey
| | - Betül Mazlum
- k Child and Adolescent Psychiatry Department, Medical Faculty , Private Clinic , Istanbul , Turkey
| | - Nursu Çakın Memik
- v Child and Adolescent Psychiatry Department, Medical Faculty , Kocaeli University , Kocaeli , Turkey
| | - Dilşad Foto Özdemir
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Hayati Sınır
- am Child and Adolescent Psychiatry Department, Medical Faculty , Kahramanmaras Sutcu Imam University , Kahramanmaraş , Turkey
| | - Bedia Ince Taşdelen
- aq Child and Adolescent Psychiatry Department, Medical Faculty , Kayseri Education and Research Hospital , Kayseri , Turkey
| | - Beril Taşkın
- k Child and Adolescent Psychiatry Department, Medical Faculty , Private Clinic , Istanbul , Turkey
| | - Çağatay Uğur
- ao Child and Adolescent Psychiatry Department, Medical Faculty , Ankara Hematology and Oncology Child Health and Diseases Training and Research Hospital , Ankara , Turkey
| | - Pınar Uran
- ar Child and Adolescent Psychiatry Department, Medical Faculty , Ankara Hospital , Ankara , Turkey
| | - Taciser Uysal
- as Child and Adolescent Psychiatry Department, Medical Faculty , Maternity and Child Health Hospital , Isparta , Turkey
| | - Özden Üneri
- ao Child and Adolescent Psychiatry Department, Medical Faculty , Ankara Hematology and Oncology Child Health and Diseases Training and Research Hospital , Ankara , Turkey
| | - Savas Yilmaz
- x Child and Adolescent Psychiatry Department, Medical Faculty , Necmettin Erbakan University , Konya , Turkey
| | - Sultan Seval Yılmaz
- j Child and Adolescent Psychiatry Department, Medical Faculty , Marmara University , Istanbul , Turkey
| | - Burak Açıkel
- x Child and Adolescent Psychiatry Department, Medical Faculty , Necmettin Erbakan University , Konya , Turkey
| | - Hüseyin Aktaş
- al Child and Adolescent Psychiatry Department, Medical Faculty , Dıcle University , Diyarbakır , Turkey
| | - Rümeysa Alaca
- al Child and Adolescent Psychiatry Department, Medical Faculty , Dıcle University , Diyarbakır , Turkey
| | - Betül Gül Alıç
- w Child and Adolescent Psychiatry Department, Medical Faculty , Ankara University , Ankara , Turkey
| | - Mahmut Almaidan
- p Child and Adolescent Psychiatry Department, Medical Faculty , Gülhane Training and Research Hospital , Ankara , Turkey
| | - Fatma Pınar Arı
- q Child and Adolescent Psychiatry Department, Medical Faculty , Osmangazi University , Eskişehir , Turkey
| | - Cihan Aslan
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Ender Atabay
- j Child and Adolescent Psychiatry Department, Medical Faculty , Marmara University , Istanbul , Turkey
| | - Merve Günay Ay
- w Child and Adolescent Psychiatry Department, Medical Faculty , Ankara University , Ankara , Turkey
| | - Hilal Aydemir
- ao Child and Adolescent Psychiatry Department, Medical Faculty , Ankara Hematology and Oncology Child Health and Diseases Training and Research Hospital , Ankara , Turkey
| | - Gülseda Ayrancı
- j Child and Adolescent Psychiatry Department, Medical Faculty , Marmara University , Istanbul , Turkey
| | - Zehra Babadagı
- ae Child and Adolescent Psychiatry Department, Medical Faculty , 19 May University, Samsun , Turkey
| | - Hasan Bayar
- s Child and Adolescent Psychiatry Department, Medical Faculty , Gaziantep University , Gaziantep , Turkey
| | - Pelin Çon Bayhan
- ab Child and Adolescent Psychiatry Department, Medical Faculty , Inonu University , Malatya , Turkey
| | - Özlem Bayram
- x Child and Adolescent Psychiatry Department, Medical Faculty , Necmettin Erbakan University , Konya , Turkey
| | - Neşe Dikmeer Bektaş
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Kıvanç Kudret Berberoğlu
- t Child and Adolescent Psychiatry Department, Medical Faculty , Trakya University , Edirne , Turkey
| | - Recep Bostan
- ag Child and Adolescent Psychiatry Department, Medical Faculty , Mersin University , Mersin , Turkey
| | - Merve Arıcı Canlı
- w Child and Adolescent Psychiatry Department, Medical Faculty , Ankara University , Ankara , Turkey
| | - Mehmet Akif Cansız
- ap Child and Adolescent Psychiatry Department, Medical Faculty , Abant Izzet Baysal University , Bolu , Turkey
| | - Cansın Ceylan
- t Child and Adolescent Psychiatry Department, Medical Faculty , Trakya University , Edirne , Turkey
| | - Neşe Coşkun
- k Child and Adolescent Psychiatry Department, Medical Faculty , Private Clinic , Istanbul , Turkey
| | - Seyma Coşkun
- s Child and Adolescent Psychiatry Department, Medical Faculty , Gaziantep University , Gaziantep , Turkey
| | - Yasemin Çakan
- m Child and Adolescent Psychiatry Department, Medical Faculty , Istanbul University , Istanbul , Turkey
| | - İbrahim Demir
- ao Child and Adolescent Psychiatry Department, Medical Faculty , Ankara Hematology and Oncology Child Health and Diseases Training and Research Hospital , Ankara , Turkey
| | - Nuran Demir
- ap Child and Adolescent Psychiatry Department, Medical Faculty , Abant Izzet Baysal University , Bolu , Turkey
| | - Esen Yıldırım Demirdöğen
- o Child and Adolescent Psychiatry Department, Medical Faculty , Ataturk University , Erzurum , Turkey
| | - Büşra Doğan
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Yunus Emre Dönmez
- ab Child and Adolescent Psychiatry Department, Medical Faculty , Inonu University , Malatya , Turkey
| | - Funda Dönder
- v Child and Adolescent Psychiatry Department, Medical Faculty , Kocaeli University , Kocaeli , Turkey
| | - Ayşegül Efe
- w Child and Adolescent Psychiatry Department, Medical Faculty , Ankara University , Ankara , Turkey
| | - Şafak Eray
- ai Child and Adolescent Psychiatry Department, Medical Faculty , Uludağ University , Bursa , Turkey
| | - Seda Erbilgin
- m Child and Adolescent Psychiatry Department, Medical Faculty , Istanbul University , Istanbul , Turkey
| | - Semih Erden
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Elif Gökçe Ersoy
- q Child and Adolescent Psychiatry Department, Medical Faculty , Osmangazi University , Eskişehir , Turkey
| | - Tuğba Eseroğlu
- e Child and Adolescent Psychiatry Department, Medical Faculty , Bakirkoy Prof. Dr. Mazhar OSMAN Training and Research Hospital for Mental Health and Nervous Disorders , Istanbul , Turkey
| | - Sümeyra Kına Fırat
- w Child and Adolescent Psychiatry Department, Medical Faculty , Ankara University , Ankara , Turkey
| | - Ezgi Eynallı Gök
- n Child and Adolescent Psychiatry Department, Medical Faculty , Çukurova University , Adana , Turkey
| | - Gülen Güler
- ag Child and Adolescent Psychiatry Department, Medical Faculty , Mersin University , Mersin , Turkey
| | - Zafer Güles
- h Child and Adolescent Psychiatry Department, Medical Faculty , Adnan Menderes University , Aydın , Turkey
| | - Serkan Güneş
- ag Child and Adolescent Psychiatry Department, Medical Faculty , Mersin University , Mersin , Turkey
| | - Adem Güneş
- at Child and Adolescent Psychiatry Department , Private clinic , Istanbul , Turkey
| | - Gülay Günay
- at Child and Adolescent Psychiatry Department , Private clinic , Istanbul , Turkey
| | - Börte Gürbüz Özgür
- h Child and Adolescent Psychiatry Department, Medical Faculty , Adnan Menderes University , Aydın , Turkey
| | - Gökçen Güven
- at Child and Adolescent Psychiatry Department , Private clinic , Istanbul , Turkey
| | - Şeyda Çelik Göksoy
- at Child and Adolescent Psychiatry Department , Private clinic , Istanbul , Turkey
| | - Havvana Horozcu
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Ayşe Irmak
- ac Child and Adolescent Psychiatry Department, Medical Faculty , Erciyes University , Kayseri , Turkey
| | - Ümit Işık
- x Child and Adolescent Psychiatry Department, Medical Faculty , Necmettin Erbakan University , Konya , Turkey
| | - Özlem Kahraman
- ac Child and Adolescent Psychiatry Department, Medical Faculty , Erciyes University , Kayseri , Turkey
| | - Bilge Merve Kalaycı
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Umut Karaaslan
- am Child and Adolescent Psychiatry Department, Medical Faculty , Kahramanmaras Sutcu Imam University , Kahramanmaraş , Turkey
| | - Mehmet Karadağ
- s Child and Adolescent Psychiatry Department, Medical Faculty , Gaziantep University , Gaziantep , Turkey
| | - Hilal Tuğba Kılıc
- w Child and Adolescent Psychiatry Department, Medical Faculty , Ankara University , Ankara , Turkey
| | - Fethiye Kılıçaslan
- z Child and Adolescent Psychiatry Department, Medical Faculty , Harran University , Sanlıurfa , Turkey
| | - Duygu Kınay
- at Child and Adolescent Psychiatry Department , Private clinic , Istanbul , Turkey
| | - Ömer Kocael
- ai Child and Adolescent Psychiatry Department, Medical Faculty , Uludağ University , Bursa , Turkey
| | - Esra Bulanık Koç
- at Child and Adolescent Psychiatry Department , Private clinic , Istanbul , Turkey
| | - Rahime Kadir Mutlu
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Zejnep Lushi-Şan
- ac Child and Adolescent Psychiatry Department, Medical Faculty , Erciyes University , Kayseri , Turkey
| | - Kevser Nalbant
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Nilüfer Okumus
- v Child and Adolescent Psychiatry Department, Medical Faculty , Kocaeli University , Kocaeli , Turkey
| | - Fatih Özbek
- at Child and Adolescent Psychiatry Department , Private clinic , Istanbul , Turkey
| | - Fatma Akkuş Özdemir
- w Child and Adolescent Psychiatry Department, Medical Faculty , Ankara University , Ankara , Turkey
| | - Hanife Özdemir
- j Child and Adolescent Psychiatry Department, Medical Faculty , Marmara University , Istanbul , Turkey
| | - Selçuk Özkan
- p Child and Adolescent Psychiatry Department, Medical Faculty , Gülhane Training and Research Hospital , Ankara , Turkey
| | - Esra Yıldırım Özyurt
- v Child and Adolescent Psychiatry Department, Medical Faculty , Kocaeli University , Kocaeli , Turkey
| | - Berna Polat
- ag Child and Adolescent Psychiatry Department, Medical Faculty , Mersin University , Mersin , Turkey
| | - Hatice Polat
- aq Child and Adolescent Psychiatry Department, Medical Faculty , Kayseri Education and Research Hospital , Kayseri , Turkey
| | - Ebru Sekmen
- ao Child and Adolescent Psychiatry Department, Medical Faculty , Ankara Hematology and Oncology Child Health and Diseases Training and Research Hospital , Ankara , Turkey
| | - Mehmet Sertçelik
- w Child and Adolescent Psychiatry Department, Medical Faculty , Ankara University , Ankara , Turkey
| | - Feyza Hatice Sevgen
- am Child and Adolescent Psychiatry Department, Medical Faculty , Kahramanmaras Sutcu Imam University , Kahramanmaraş , Turkey
| | - Oğuz Sevince
- n Child and Adolescent Psychiatry Department, Medical Faculty , Çukurova University , Adana , Turkey
| | - Funda Süleyman
- at Child and Adolescent Psychiatry Department , Private clinic , Istanbul , Turkey
| | - Ülker Shamkhalova
- n Child and Adolescent Psychiatry Department, Medical Faculty , Çukurova University , Adana , Turkey
| | - Nurcan Eren Şimşek
- v Child and Adolescent Psychiatry Department, Medical Faculty , Kocaeli University , Kocaeli , Turkey
| | - Yaşar Tanır
- w Child and Adolescent Psychiatry Department, Medical Faculty , Ankara University , Ankara , Turkey
| | - Mehmet Tekden
- at Child and Adolescent Psychiatry Department , Private clinic , Istanbul , Turkey
| | - Seyhan Temtek
- ao Child and Adolescent Psychiatry Department, Medical Faculty , Ankara Hematology and Oncology Child Health and Diseases Training and Research Hospital , Ankara , Turkey
| | - Melike Topal
- at Child and Adolescent Psychiatry Department , Private clinic , Istanbul , Turkey
| | - Zehra Topal
- ap Child and Adolescent Psychiatry Department, Medical Faculty , Abant Izzet Baysal University , Bolu , Turkey
| | - Tuğba Türk
- at Child and Adolescent Psychiatry Department , Private clinic , Istanbul , Turkey
| | - Halit Necmi Uçar
- ai Child and Adolescent Psychiatry Department, Medical Faculty , Uludağ University , Bursa , Turkey
| | - Filiz Uçar
- ae Child and Adolescent Psychiatry Department, Medical Faculty , 19 May University, Samsun , Turkey
| | - Duygu Uygun
- ao Child and Adolescent Psychiatry Department, Medical Faculty , Ankara Hematology and Oncology Child Health and Diseases Training and Research Hospital , Ankara , Turkey
| | - Necati Uzun
- x Child and Adolescent Psychiatry Department, Medical Faculty , Necmettin Erbakan University , Konya , Turkey
| | - Zeynep Vatansever
- v Child and Adolescent Psychiatry Department, Medical Faculty , Kocaeli University , Kocaeli , Turkey
| | - Neslihan Gökçe Yazgılı
- ah Child and Adolescent Psychiatry Department, Medical Faculty , Hacettepe University , Ankara , Turkey
| | - Dilşat Miniksar Yıldız
- ab Child and Adolescent Psychiatry Department, Medical Faculty , Inonu University , Malatya , Turkey
| | - Nazike Yıldız
- t Child and Adolescent Psychiatry Department, Medical Faculty , Trakya University , Edirne , Turkey
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18
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Karacetin G, Arman AR, Fis NP, Demirci E, Ozmen S, Hesapcioglu ST, Oztop D, Tufan AE, Tural U, Aktepe E, Aksu H, Ardic UA, Basgul S, Bilac O, Coskun M, Celik GG, Demirkaya SK, Dursun OB, Durukan I, Fidan T, Gencoglan S, Gokcen C, Gokten ES, Gorker I, Gormez V, Gundogdu OY, Gurkan CK, Herguner S, Kandemir H, Kilic BG, Kilincaslan A, Mutluer T, Nasiroglu S, Ozcan OO, Ozturk M, Sapmaz SY, Suren S, Sahin N, Tahiroglu AY, Toros F, Unal F, Vural P, Yazici IP, Yazici KU, Yildirim V, Yulaf Y, Yuce M, Yuksel T, Akdemir D, Altun H, Ayik B, Bilgic A, Bozkurt OH, Cakir ED, Ceri V, Demir NU, Dinc G, Irmak MY, Karaman D, Kinik MF, Mazlum B, Memik NC, Ozdemir DF, Sinir H, Tasdelen BI, Taskin B, Ugur C, Uran P, Uysal T, Uneri OS, Yilmaz S, Yilmaz SS, Acikel B, Aktas H, Alaca R, Alic BG, Almbaidheen M, Ari FP, Aslan C, Atabay E, Ay MG, Aydemir H, Ayranci G, Babadagi Z, Bayar H, Bayhan PC, Bayram O, Bektas ND, Berberoglu KK, Bostan R, Cakan Y, Canli MA, Cansiz MA, Ceylan C, Coskun N, Coskun S, Demir I, Demir N, Demirdogen EY, Dogan B, Donmez YE, Donder F, Efe A, Eray S, Erbilgin S, Erden S, Ersoy EG, Eseroglu T, Firat SK, Gok EE, Goksoy SC, Guler G, Gules Z, Gunay G, Gunes S, Gunes A, Guven G, Horozcu H, Irmak A, Isik U, Kahraman O, Kalayci BM, Karaaslan U, Karadag M, Kilic HT, Kilicaslan F, Kinay D, Koc EB, Kocael O, Mutlu RK, San Z, Nalbant K, Okumus N, Ozbek F, Ozdemir FA, Ozdemir H, Ozgur BG, Ozkan S, Ozyurt EY, Polat B, Polat H, Sekmen E, Sertcelik M, Sevgen FH, Sevince O, Shamkhalova U, Suleyman F, Simsek NE, Tanir Y, Tekden M, Temtek S, Topal M, Topal Z, Turk T, Ucar HN, Ucar F, Uygun D, Uzun N, Vatansever Z, Yazgili NG, Yildiz DM, Yildiz N, Ercan ES. Prevalence of Childhood Affective disorders in Turkey: An epidemiological study. J Affect Disord 2018; 238:513-521. [PMID: 29936389 DOI: 10.1016/j.jad.2018.05.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 04/24/2018] [Accepted: 05/13/2018] [Indexed: 12/17/2022]
Abstract
AIM To determine the prevalence of affective disorders in Turkey among a representative sample of Turkish population. METHODS This study was conducted as a part of the "The Epidemiology of Childhood Psychopathology in Turkey" (EPICPAT-T) Study, which was designed by the Turkish Association of Child and Adolescent Mental Health. The inclusion criterion was being a student between the second and fourth grades in the schools assigned as study centers. The assessment tools used were the K-SADS-PL, and a sociodemographic form that was designed by the authors. Impairment was assessed via a 3 point-Likert type scale independently rated by a parent and a teacher. RESULTS A total of 5842 participants were included in the analyses. The prevalence of affective disorders was 2.5 % without considering impairment and 1.6 % when impairment was taken into account. In our sample, the diagnosis of bipolar disorder was lacking, thus depressive disorders constituted all the cases. Among depressive disorders with impairment, major depressive disorder (MDD) (prevalence of 1.06%) was the most common, followed by dysthymia (prevalence of 0.2%), adjustment disorder with depressive features (prevalence of 0.17%), and depressive disorder-NOS (prevalence of 0.14%). There were no statistically significant gender differences for depression. Maternal psychopathology and paternal physical illness were predictors of affective disorders with pervasive impairment. CONCLUSION MDD was the most common depressive disorder among Turkish children in this nationwide epidemiological study. This highlights the severe nature of depression and the importance of early interventions. Populations with maternal psychopathology and paternal physical illness may be the most appropriate targets for interventions to prevent and treat depression in children and adolescents.
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Affiliation(s)
- Gul Karacetin
- University of Health Sciences, Bakirkoy Research and Training Hospital for Psychiatric and Neurological Diseases, Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Ayse Rodopman Arman
- Marmara University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Nese Perdahli Fis
- Marmara University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Esra Demirci
- Erciyes University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Kayseri, Turkey.
| | - Sevgi Ozmen
- Erciyes University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Kayseri, Turkey.
| | - Selma Tural Hesapcioglu
- Karadeniz Technical University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Trabzon, Turkey.
| | - Didem Oztop
- Erciyes University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Kayseri, Turkey.
| | - Ali Evren Tufan
- Abant Izzet Baysal University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Bolu, Turkey.
| | - Umit Tural
- Kocaeli University, Department of Psychiatry, Kocaeli, Turkey.
| | - Evrim Aktepe
- Suleyman Demirel University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Isparta, Turkey.
| | - Hatice Aksu
- Adnan Menderes University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Aydin, Turkey.
| | - Ulku Akyol Ardic
- Denizli State Hospital, Child and Adolescent Psychiatry, Denizli, Turkey.
| | - Senem Basgul
- Hasan Kalyoncu University, Department of Psychology, Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Oznur Bilac
- Manisa Mental Health and Diseases Hospital Child and Adolescent Psychiatry, Manisa, Turkey.
| | - Murat Coskun
- Istanbul University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Gonca Gul Celik
- Cukurova University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Adana, Turkey.
| | - Sevcan Karakoc Demirkaya
- Adnan Menderes University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Aydin, Turkey.
| | - Onur Burak Dursun
- Ataturk University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Erzurum, Turkey.
| | - Ibrahim Durukan
- University of Health Sciences Gulhane Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Tulin Fidan
- Osmangazi University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Eskisehir, Turkey.
| | - Salih Gencoglan
- Yuzuncu Yil University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Van, Turkey.
| | - Cem Gokcen
- Gaziantep University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Gaziantep, Turkey.
| | - Emel Sari Gokten
- University of Health Sciences, Bursa Yuksek Ihtisas Hospital, Child and Adolescent Psychiatry, Bursa, Turkey.
| | - Isık Gorker
- Trakya University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Edirne, Turkey.
| | - Vahdet Gormez
- Istanbul Medeniyet University, Department of Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Ozlem Yildiz Gundogdu
- Kocaeli University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Kocaeli, Turkey.
| | - Cihat Kagan Gurkan
- Ankara University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Sabri Herguner
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Child and Adolescent Psychiatry, Konya, Turkey.
| | - Hasan Kandemir
- Harran University Faculty of Medicine, Child and Adolescent Psychiatry Department, Sanliurfa, Turkey.
| | - Birim Gunay Kilic
- Ankara University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Ayse Kilincaslan
- Istanbul University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Tuba Mutluer
- Van Training and Research Hospital, Department of Child and Adolescent Psychiatry, Van, Turkey.
| | - Serhat Nasiroglu
- Sakarya University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Sakarya, Turkey.
| | - Ozlem Ozel Ozcan
- Inonu University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Malatya, Turkey.
| | - Mucahit Ozturk
- Hasan Kalyoncu University, Department of Psychology, Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Sermin Yalin Sapmaz
- Celal Bayar University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Manisa, Turkey.
| | - Serkan Suren
- Samsun Medical Park Hospital, Child and Adolescent Psychiatry, Samsun, Turkey.
| | - Nilfer Sahin
- Mugla Sitki Kocman University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Mugla, Turkey.
| | - Aysegul Yolga Tahiroglu
- Cukurova University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Adana, Turkey.
| | - Fevziye Toros
- Mersin University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Mersin, Turkey.
| | - Fatih Unal
- Hacettepe University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Pinar Vural
- Uludag University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Bursa, Turkey.
| | | | - Kemal Utku Yazici
- Firat University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Elazig, Turkey.
| | - Veli Yildirim
- Mersin University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Mersin, Turkey.
| | - Yasemin Yulaf
- Private Practice, Child and Adolescent Psychiatry, Tekirdag, Turkey.
| | - Murat Yuce
- Ondokuz Mayis University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Samsun, Turkey.
| | - Tugba Yuksel
- Dicle University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Diyarbakir, Turkey.
| | - Devrim Akdemir
- Hacettepe University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Hatice Altun
- Kahramanmaras Sutcu Imam University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Kahramanmaras, Turkey..
| | - Basak Ayik
- University of Health Sciences, Bakirkoy Research and Training Hospital for Psychiatric and Neurological Diseases, Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Ayhan Bilgic
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Child and Adolescent Psychiatry, Konya, Turkey.
| | - Ozlem Hekim Bozkurt
- University of Health Sciences, Ankara Child Health and Diseases Hematology and Oncology Training and Research Hospital, Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Emine Demirbas Cakir
- Abant Izzet Baysal University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Bolu, Turkey.
| | - Veysi Ceri
- Marmara University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Nagehan Ucok Demir
- Marmara University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Gulser Dinc
- University of Health Sciences, Ankara Child Health and Diseases Hematology and Oncology Training and Research Hospital, Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Mustafa Yasin Irmak
- Marmara University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Dursun Karaman
- University of Health Sciences Gulhane Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Mehmet Fatih Kinik
- Kocaeli University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Kocaeli, Turkey.
| | - Betul Mazlum
- Acibadem Mehmet Ali Aydinlar University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Nursu Cakin Memik
- Kocaeli University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Kocaeli, Turkey.
| | - Dilsad Foto Ozdemir
- Hacettepe University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Hayati Sinir
- Kahramanmaras Sutcu Imam University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Kahramanmaras, Turkey..
| | - Bedia Ince Tasdelen
- Ankara University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Beril Taskin
- Private Doctor, Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Cagatay Ugur
- University of Health Sciences, Ankara Child Health and Diseases Hematology and Oncology Training and Research Hospital, Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Pınar Uran
- Ankara University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Taciser Uysal
- Ege University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Izmir, Turkey.
| | - Ozden Sukran Uneri
- University of Health Sciences, Ankara Child Health and Diseases Hematology and Oncology Training and Research Hospital, Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Savas Yilmaz
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Child and Adolescent Psychiatry, Konya, Turkey.
| | - Sultan Seval Yilmaz
- Ankara University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Burak Acikel
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Child and Adolescent Psychiatry, Konya, Turkey.
| | - Huseyin Aktas
- Dicle University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Diyarbakir, Turkey.
| | - Rumeysa Alaca
- Dicle University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Diyarbakir, Turkey.
| | - Betul Gul Alic
- University of Health Sciences, Ankara Child Health and Diseases Hematology and Oncology Training and Research Hospital, Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Mahmoud Almbaidheen
- University of Health Sciences Gulhane Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Fatma Pinar Ari
- Osmangazi University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Eskisehir, Turkey.
| | - Cihan Aslan
- Hacettepe University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Ender Atabay
- Marmara University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Merve Gunay Ay
- Ankara University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Hilal Aydemir
- University of Health Sciences, Ankara Child Health and Diseases Hematology and Oncology Training and Research Hospital, Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Gülseda Ayranci
- Marmara University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Zehra Babadagi
- Ondokuz Mayis University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Samsun, Turkey.
| | - Hasan Bayar
- Gaziantep University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Gaziantep, Turkey.
| | - Pelin Con Bayhan
- Inonu University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Malatya, Turkey.
| | - Ozlem Bayram
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Child and Adolescent Psychiatry, Konya, Turkey.
| | - Nese Dikmeer Bektas
- Hacettepe University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Kivanc Kudret Berberoglu
- Trakya University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Edirne, Turkey.
| | - Recep Bostan
- Mersin University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Mersin, Turkey.
| | - Yasemin Cakan
- Istanbul University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Merve Arici Canli
- Ankara University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Mehmet Akif Cansiz
- Istanbul University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Cansin Ceylan
- Trakya University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Edirne, Turkey.
| | - Nese Coskun
- Istanbul University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Seyma Coskun
- Gaziantep University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Gaziantep, Turkey.
| | - Ibrahim Demir
- University of Health Sciences, Ankara Child Health and Diseases Hematology and Oncology Training and Research Hospital, Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Nuran Demir
- Abant Izzet Baysal University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Bolu, Turkey.
| | - Esen Yildirim Demirdogen
- Ataturk University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Erzurum, Turkey.
| | - Busra Dogan
- Hacettepe University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Yunus Emre Donmez
- Ankara University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Funda Donder
- Kocaeli University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Kocaeli, Turkey.
| | - Aysegul Efe
- Ankara University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Safak Eray
- Uludag University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Bursa, Turkey.
| | - Seda Erbilgin
- Istanbul University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Semih Erden
- Hacettepe University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Elif Gokce Ersoy
- Osmangazi University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Eskisehir, Turkey.
| | - Tugba Eseroglu
- University of Health Sciences, Bakirkoy Research and Training Hospital for Psychiatric and Neurological Diseases, Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Sumeyra Kina Firat
- Ankara University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Ezgi Eynalli Gok
- Cukurova University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Adana, Turkey.
| | - Seyda Celik Goksoy
- Istanbul University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Gulen Guler
- Mersin University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Mersin, Turkey.
| | - Zafer Gules
- Adnan Menderes University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Aydin, Turkey.
| | - Gulay Gunay
- University of Health Sciences, Bakirkoy Research and Training Hospital for Psychiatric and Neurological Diseases, Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Serkan Gunes
- Mersin University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Mersin, Turkey.
| | - Adem Gunes
- Istanbul University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Gokcen Guven
- Istanbul University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Havvana Horozcu
- Hacettepe University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Ayse Irmak
- Erciyes University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Kayseri, Turkey.
| | - Umit Isik
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Child and Adolescent Psychiatry, Konya, Turkey.
| | - Ozlem Kahraman
- Erciyes University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Kayseri, Turkey.
| | - Bilge Merve Kalayci
- Hacettepe University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Umut Karaaslan
- Dicle University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Diyarbakir, Turkey.
| | - Mehmet Karadag
- Gaziantep University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Gaziantep, Turkey.
| | - Hilal Tugba Kilic
- Ankara University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Fethiye Kilicaslan
- Harran University Faculty of Medicine, Child and Adolescent Psychiatry Department, Sanliurfa, Turkey.
| | - Duygu Kinay
- Istanbul University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Esra Bulanik Koc
- University of Health Sciences, Bakirkoy Research and Training Hospital for Psychiatric and Neurological Diseases, Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Omer Kocael
- Uludag University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Bursa, Turkey.
| | - Rahime Kadir Mutlu
- Hacettepe University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Zejnep San
- Erciyes University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Kayseri, Turkey.
| | - Kevser Nalbant
- Hacettepe University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Nilufer Okumus
- Kocaeli University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Kocaeli, Turkey.
| | - Fatih Ozbek
- University of Health Sciences, Bakirkoy Research and Training Hospital for Psychiatric and Neurological Diseases, Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Fatma Akkus Ozdemir
- Ankara University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Hanife Ozdemir
- Marmara University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Borte Gurbuz Ozgur
- Adnan Menderes University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Aydin, Turkey.
| | - Selcuk Ozkan
- University of Health Sciences Gulhane Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Esra Yildirim Ozyurt
- Kocaeli University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Kocaeli, Turkey.
| | - Berna Polat
- Mersin University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Mersin, Turkey.
| | - Hatice Polat
- Erciyes University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Kayseri, Turkey.
| | - Ebru Sekmen
- University of Health Sciences, Ankara Child Health and Diseases Hematology and Oncology Training and Research Hospital, Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Mehmet Sertcelik
- Ankara University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Feyza Hatice Sevgen
- Kahramanmaras Sutcu Imam University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Kahramanmaras, Turkey..
| | - Oguz Sevince
- Cukurova University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Adana, Turkey.
| | - Ulker Shamkhalova
- Cukurova University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Adana, Turkey.
| | - Funda Suleyman
- Istanbul University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Nurcan Eren Simsek
- Kocaeli University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Kocaeli, Turkey.
| | - Yasar Tanir
- Ankara University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Mehmet Tekden
- University of Health Sciences, Bakirkoy Research and Training Hospital for Psychiatric and Neurological Diseases, Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Seyhan Temtek
- University of Health Sciences, Ankara Child Health and Diseases Hematology and Oncology Training and Research Hospital, Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Melike Topal
- University of Health Sciences, Bakirkoy Research and Training Hospital for Psychiatric and Neurological Diseases, Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Zehra Topal
- Abant Izzet Baysal University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Bolu, Turkey.
| | - Tugba Turk
- University of Health Sciences, Bakirkoy Research and Training Hospital for Psychiatric and Neurological Diseases, Child and Adolescent Psychiatry, Istanbul, Turkey.
| | - Halit Necmi Ucar
- Uludag University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Bursa, Turkey.
| | - Filiz Ucar
- Ondokuz Mayis University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Samsun, Turkey.
| | - Duygu Uygun
- University of Health Sciences, Ankara Child Health and Diseases Hematology and Oncology Training and Research Hospital, Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Necati Uzun
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Child and Adolescent Psychiatry, Konya, Turkey.
| | - Zeynep Vatansever
- Kocaeli University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Kocaeli, Turkey.
| | - Neslihan Gokce Yazgili
- Hacettepe University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Dilsad Miniksar Yildiz
- Inonu University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Malatya, Turkey.
| | - Nazike Yildiz
- Trakya University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Edirne, Turkey.
| | - Eyup Sabri Ercan
- Ege University Faculty of Medicine, Department of Child and Adolescent Psychiatry, Izmir, Turkey.
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Yildiz M, Erim R, Soygur H, Tural U, Kiras F, Gules E. Development and validation of the Subjective Recovery Assessment Scale for patients with schizophrenia. PSYCHIAT CLIN PSYCH 2017. [DOI: 10.1080/24750573.2017.1405579] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Mustafa Yildiz
- Department of Psychiatry, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Rahsan Erim
- Department of Psychiatry, Izzet Baysal University School of Medicine, Bolu, Turkey
| | | | - Umit Tural
- Department of Psychiatry, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Fatma Kiras
- Department of Psychiatry, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Emrah Gules
- Erenkoy Mental and Neurological Diseases State Hospital, Istanbul, Turkey
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20
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Abstract
It has been suggested that the treatment strategy needs to be reviewed and changed if depression occurs in patients with posttraumatic stress disorder (PTSD). We analyzed data extracted from the Marmara Epidemiological Survey (MES) which had examined 683 survivors at 3 years after a devastating earthquake. Fifty three cases (40.5%) out of the 131 cases with PTSD had also been diagnosed with MDD. Comorbid PTSD and MDD group has significantly lower rates of recovery from PTSD in comparison to PTSD without MDD (26.4% vs. 47.4% respectively). Rates of past psychiatric disorder and past traumatic experience were significantly more frequent among the comorbid group. Moreover, comorbidity of PTSD and MDD was clearly associated with greater psychological distress, more severe PTSD, and diminished perceived social support. Past psychiatric disorder, General Health Questionnaire (GHQ-12) and Multidimensional Scale of Perceived Social Scale (MSPSS) total scores succeeded in predicting the comorbidity of PTSD and MDD significantly.
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Affiliation(s)
- Umit Tural
- Department of Psychiatry, Medical Faculty of Kocaeli University, Umuttepe, Kocaeli, Turkey.
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Dumlu K, Orhon Z, Özerdem A, Tural U, Ulaş H, Tunca Z. Treatment-induced manic switch in the course of unipolar depression can predict bipolarity: cluster analysis based evidence. J Affect Disord 2011; 134:91-101. [PMID: 21742381 DOI: 10.1016/j.jad.2011.06.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Revised: 06/16/2011] [Accepted: 06/16/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Antidepressants are known to induce manic switch in patients with depression. Treatment-induced mania is not considered as bipolar disorder in DSM IV. The aim of this study was to assess whether clinical characteristics of patients with unipolar depression with a history of treatment-induced mania were similar to those of patients with bipolar disorder. METHOD The study included 217 consecutive patients with DSM-IV mood disorders, diagnosed as: bipolar disorder type I (BP-I, n = 58) or type II (BP-II, n = 18) whose first episodes were depression, recurrent (unipolar) major depressive disorder with a history of antidepressant treatment-induced mania (switchers = sUD; n = 61) and without such an event (rUD; n = 80). First, the groups were compared with regard to clinical features and course specifiers using variance and chi-square analysis. Variables that differed significantly between the four groups were included in two-step cluster analysis to explore naturally occurring subgroups in all diagnoses. Subsequently, the relationship between the naturally occurring clusters and pre-defined DSM-IV diagnoses were investigated. RESULTS Two-step cluster analysis revealed two different naturally occurring groups. Higher severity of depressive episodes, with higher rate of melancholic features, higher number of hospitalization and suicide attempts were represented in one cluster where switchers (77%), bipolar I (94.8%) and II (83.3%) patients clustered together. CONCLUSION The findings of this study confirm that treatment-induced mania is a clinical phenomenon that belongs within the bipolar spectrum rather than a coincidental treatment complication, and that it should be placed under "bipolar disorders" in future classification systems. LIMITATIONS The study includes the limitations of any naturalistic retrospective study.
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Affiliation(s)
- Kemal Dumlu
- Department of Psychiatry, Dokuz Eylul University, School of Medicine, Izmir, Turkey
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22
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Abstract
AIM The aim of the present study was to evaluate demographics, clinical features, psychiatric diagnoses and prognosis of neuroleptic malignant syndrome (NMS) reported in Turkey, and to assess their association with mortality. METHODS Data on all reported cases of NMS in the Turkish Psychiatric Index between 1985 and 2005 were collected. The type, dosage and administration period of neuroleptics, the clinical and laboratory findings; and prognosis were compared in terms of mortality. RESULTS Thirty-six patients with a mean age of 33.67 +/- 16.98 years were identified. Fifteen (41.7%) were diagnosed as having schizophrenia or other psychotic disorders and the same number were diagnosed as having affective disorder. Remaining five (13.9%) were diagnosed with other psychiatric disorders and 1 (2.7%) had no psychiatric diagnosis. Twenty-two (61.1%) of the NMS cases were associated with high potency typical neuroleptics. Association between an atypical antipsychotic and NMS has been reported in one case. NMS appeared within 7 days after initiation of the antipsychotic medication in the majority of samples (n = 19, 52.8%). Several combinations of rescue treatments were used in the majority of cases (n = 19, 52.8%), although bromocriptine (n = 22, 61.1%) was the most frequently preferred rescue treatment for NMS. Benzodiazepines were significantly better than the other treatment options in preventing mortality. Five out of the 36 patients (13.9%) with NMS had died. Age was the only significant independent factor that was associated with mortality. CONCLUSIONS Benzodiazepines may be included in the treatment of NMS. The mortality rate due to NMS in Turkey was lower than the previously reported rates from other developing countries.
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Affiliation(s)
- Umit Tural
- Department of Psychiatry, Medical Faculty, Kocaeli University, Kocaeli, Turkey.
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23
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Abstract
Panic disorder (PD) is a heterogeneous phenomenon with respect to symptom profile. Most studies agree that a group of patients with prominent respiratory symptoms emerged as a distinct PD subtype. In this study we compared a range of clinical features associated with PD and agoraphobia in patients with respiratory (RS) and nonrespiratory (NRS) subtypes of PD. The participants were 124 patients with PD (79 women and 45 men), with or without agoraphobia, diagnosed by DSM-IV criteria. Following the observer-rated Panic Disorder Severity Scale assessment, subjects completed self-report measures, including the Anxiety Sensitivity Index (ASI), Panic-Agoraphobia Scale; the Beck Anxiety Inventory; and the Panic-Agoraphobic Spectrum Scale (PAS-SR). Multivariate analysis of variance (MANOVA) showed significant group differences [Pillai's trace = 0.95, F (5, 118)(=)2.48, P = .036]. Patients in RS group had higher mean total scores on the ASI (F = 5.00, df = 1, P = .027) and PAS-SR (F = 11.23, df = 1, P = .001) than patients in NRS group. Also, patients with RS attained higher scores than patients with NRS on four domains of PAS-SR (panic-like symptoms, agoraphobia, separation sensitivity, and reassurance seeking). A descriptive discriminant analysis of the data correctly identified 69.4% of the patient group in general and 86.1% of RS group (Wilks's lambda = 0.87, df = 8, P = .048). The significant discriminating factors of the RS and NRS groups were domains of panic-like symptoms, agoraphobia, separation sensitivity, and reassurance seeking. Our findings suggest that anxiety sensitivity and panic-agoraphobic spectrum symptoms might be particularly relevant to understanding subtypes of PD.
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Affiliation(s)
- Elif Onur
- Department of Psychiatry, Medical Faculty of Dokuz Eylül University, Izmir, Turkey.
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Alkin T, Tural U, Onur E, Oztürk V, Monkul ES, Kutluk K. Basilar artery blood flow velocity changes in patients with panic disorder following 35% carbon dioxide challenge. Prog Neuropsychopharmacol Biol Psychiatry 2007; 31:115-22. [PMID: 16989929 DOI: 10.1016/j.pnpbp.2006.08.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2006] [Revised: 06/15/2006] [Accepted: 08/08/2006] [Indexed: 11/16/2022]
Abstract
PURPOSE We compared the mean basilar artery blood flow velocity (BABFV) between patients with panic disorder and healthy subjects both at rest and immediately following carbon dioxide (CO(2)) challenge, and examined the effects of treatment on BABFV. METHODS Twenty four patients with panic disorder with or without agoraphobia and 12 healthy comparison subjects were studied. Visual Analog Anxiety Scale was used to evaluate the anxiogenic effect of 35% CO(2) inhalation. Mean BABFV was monitored using transcranial Doppler ultrasonography at rest and 10, 20, 30, 60, 90, 120 s after 35% CO(2) challenge both before and after four weeks treatment with paroxetine. RESULTS The hemodynamic response pattern of basilar artery to CO(2) inhalation was significantly different between two groups. CO(2) rapidly triggered blood flow velocity in basilar artery amongst panic patients but not in healthy comparisons. The mean time to normalization of BABFV was significantly longer in panic patients. Four weeks of treatment with paroxetine led to a significantly reduced mean BABFV after 35% CO(2) inhalation in comparison with pretreatment. CONCLUSIONS Patients with panic disorder had impaired cerebral regulatory mechanisms observed as a change in response characteristics in BABFV in response to CO(2) inhalation. Treatment with paroxetine reduced the increase of BABFV seen in patients after the CO(2) challenge.
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Affiliation(s)
- Tunç Alkin
- Department of Psychiatry, Medical Faculty of Dokuz Eylül University, Izmir, Turkey.
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Onder E, Tural U, Aker T, Kiliç C, Erdoğan S. Prevalence of psychiatric disorders three years after the 1999 earthquake in Turkey: Marmara Earthquake Survey (MES). Soc Psychiatry Psychiatr Epidemiol 2006; 41:868-74. [PMID: 16906439 DOI: 10.1007/s00127-006-0107-6] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/26/2006] [Indexed: 10/24/2022]
Abstract
BACKGROUND The objective of the study is to describe the community prevalence of psychiatric disorder, mainly posttraumatic stress disorder (PTSD) and Major Depressive Disorder (MDD) 3 years after a devastating earthquake. METHODS Three years after the Marmara Earthquake, 683 individuals from the epicentre were randomly selected to form a representative sample and were assessed with Composite International Diagnostic Interview (CIDI), General Health Questionnaire (GHQ), Traumatic Stress Symptom Checklist (TSSC) and Beck Depression Inventory (BDI). RESULTS The 36 months prevalence of PTSD and MDD after the Marmara Earthquake were 19.2% and 18.7% respectively. The current prevalence of PTSD and MDD in the affected community was found to be 11.7% and 10.5%, respectively. PTSD and MDD were the most prevalent disorders after the disaster and showed a decrease over time. However, only 38.9% of the PTSD cases identified at any time over the 3 years were in remission at the 3rd-year. The co-occurrence of MDD with PTSD resulted in a decrease in the rate of recovery from PTSD. MDD was also the most prevalent disorder accompanying PTSD. Of all the subjects 37.5% with PTSD still met the MDD criteria at the 3rd year postearthquake. CONCLUSIONS In comparison with the data from pre-earthquake national mental health profile, the present study showed that the prevalence of MDD, panic disorder, OCD, GAD, social phobia and special phobias were still higher in the affected region 3 years after the earthquake.
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Affiliation(s)
- Emin Onder
- Department of Psychiatry, Medical Faculty of Kocaeli University, Kocaeli, Turkey
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Uneri O, Tural U, Cakin Memik N. [Smoking and schizophrenia: where is the biological connection?]. Turk Psikiyatri Derg 2006; 17:55-64. [PMID: 16528636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
OBJECTIVE Patients with psychiatric disorders have a higher incidence of smoking than the general population. In particular, the rate of smoking among patients with schizophrenia has been found to be between two and three times in the general population in western countries. This paper reviews the biological factors that might be contributing to the high rate of smoking among patients with schizophrenia and examines the interaction between nicotine and neurobiological disturbances observed in schizophrenia. METHOD Papers assessing the possible biological causes of smoking in patients with schizophrenia and the physiological effects of nicotine were reviewed by using the key words "nicotine, schizophrenia, smoking and cigarette" in Pubmed, Turk Medline, and the Turkish Psychiatric Index. RESULTS Studies conducted in humans and animals show that nicotine can directly increase dopaminergic transmission in the central nervous system, enhance cognitive performance and improve sensory gating deficits observed in patients with schizophrenia. Moreover, smoking diminishes the efficacy of most antipsychotic drugs via an increased hepatic metabolism. CONCLUSION Studies suggest a link between the physiological effects of nicotine and the neurobiological disturbances in schizophrenia. Disturbances in the cholinergic transmission may be responsible for some symptoms of schizophrenia. The harmful effects of smoking vastly outweigh any possible benefits, but, nevertheless, further investigation may lead to important insights regarding the etiology of schizophrenia at a molecular level.
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Affiliation(s)
- Ozden Uneri
- Cocuk Psikiyatrisi AD, Kocaeli U Tip Fak, Psikiyatri AD, Kocaeli
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Abstract
Objective. Reboxetine is a selective noradrenaline reuptake inhibitor (NaRI), a study on the effects of reboxetine on amenorrhea has not been reported in the literature up to now. This report describes a patient with symptoms of amenorrhea which is thought to be caused by reboxetine. Case. A female patient with major depressive disorder was given reboxetine 8 mg/day. She had experienced secondary amenorrhea for 3 months. The patient had no periodic irregularity before reboxetine use, and after reboxetine was discontinued menstruation resumed. After another trial with reboxetine at the optimal dose (8 mg/day, increased gradually), the patient reported amenorrhea again for 2 months. On discontinuing reboxetine, her menstrual cycle became regular again. Discussion. FSH, LH, E2 and prolactin levels were normal in our patient. Because amenorrhea was temporally related with reboxetine trials, we posit that this phenomenon may be due to side effects of reboxetine. This may be due to noraderenergic effects on hormonal function.
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Affiliation(s)
- I Yalug
- Department of Psychiatry, University Medical Faculty, Kocaeli, Turkey
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Abstract
We assessed the reliability and validity of the Turkish version of the seven-item Panic Disorder Severity Scale (PDSS). We recruited 174 subjects, including 104 with current DSM-IV panic disorder with (n=76) or without(n=28)agoraphobia, 14 with a major depressive episode, 24 with a non-panic anxiety disorder, and 32 healthy controls. Assessment instruments were Panic Disorder Severity Scale, Panic and Agoraphobia Scale, both the observer-rated (P&Ao) and self-rating (P& Asr); Clinical Global Impression Scale (CGI); Hamilton Anxiety Scale, and Beck Depression Inventory. We repeated the measures for a group of panic disorder patients (n = 51) after 4 weeks to assess test-retest reliability. The internal consistency (Cronbach's alpha) of the PDSS was .92-94. The inter-rater correlation coefficient was .79. The test-retest correlation coefficient after 4 weeks was .63. In discriminant validity analyses, the highest correlation for PDSS was with P&Ao, P&Asr (r=.87 and.87, respectively) and CGI (r=.76) and the lowest with Beck Depression Inventory (r=.29). The cut-off point was six/seven, associated with high sensitivity (99%) and specificity (98%). This study confirmed the objectivity, reliability and validity of the Turkish version of the PDSS.
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Affiliation(s)
- E Serap Monkul
- Department of Psychiatry, Dokuz Eylül University, Izmir, Turkey.
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Tural U, Coşkun B, Onder E, Corapçioğlu A, Yildiz M, Kesepara C, Karakaya I, Aydin M, Erol A, Torun F, Aybar G. Psychological consequences of the 1999 earthquake in Turkey. J Trauma Stress 2004; 17:451-9. [PMID: 15730063 DOI: 10.1007/s10960-004-5793-9] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We explored the prevalence of posttraumatic stress disorder (PTSD) and its relation to demographic characteristics and other risk factors for developing PTSD in a large sample (N = 910) of earthquake survivors living in tent city. Twenty-five percent of the sample met DSM-IV criteria for PTSD assessed with the Posttraumatic Stress Disorder Self Test (PTSD-S). Peritraumatic factors explained the most variance when the risk factors were grouped as demographics, pretraumatic, peritraumatic, and posttraumatic. The study emphasized that PTSD among the earthquake victims was as prevalent in Turkey as after disasters in other developing countries but higher than usually found after disasters in developed countries, and there was a relation between some factors-mostly peritraumatic-and PTSD.
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Affiliation(s)
- Umit Tural
- Department of Psychiatry, Medical School of Kocaeli University, Derince - Izmit, Turkey.
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Tural U, Onder E. Fluoxetine once every third day in the treatment of major depressive disorder. Eur Arch Psychiatry Clin Neurosci 2003; 253:307-12. [PMID: 14714120 DOI: 10.1007/s00406-003-0445-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2003] [Accepted: 07/03/2003] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Fluoxetine and its active metabolite norfluoxetine have long half-lives. We postulate that, owing to the long elimination half-life and the time to reach steady-state level in plasma is nearly four weeks, patients diagnosed with major depressive disorder might be treated with fluoxetine taken once every third day, after being treated initially during 4 weeks with daily doses of fluoxetine. METHODS In this open label, 12-weeks, randomized, prospective study, patients diagnosed with DSM-IV major depressive disorder were randomly assigned into 1 of 3 treatment groups. Thirty-four patients took 20 mg and 32 patients took 40 mg of fluoxetine daily throughout the study. Twenty-nine patients had been taking 20 mg of fluoxetine daily for 4 weeks of the study initially, and then were switched to 20 mg fluoxetine once every third day regime. The severity of depression was assessed by Hamilton Depression Rating Scale (HDRS) and Clinical Global Impressions- Severity Scale (CGI-S). Response was defined as a 50% or greater reduction of the baseline HDRS total score. After defining a strict criterion of relapse, time to relapse was estimated using survival analyses (Kaplan-Meier method). RESULTS The repeated measures analysis of variance (ANOVA) of HDRS found a significant time effect (F = 464.04, df = 1.00, p < 0.001), but no significant group effects (F = 0.84, df = 2.00,p = 0.433) from baseline through week 12. The proportion of responders was not significantly different between the treatment groups at the endpoint. Survival analyses showed, however, a significant delayed mean time to relapse in patients treated with 40 mg of fluoxetine daily compared to either patients treated with 20 mg of fluoxetine daily or 20 mg fluoxetine once every third day. The mean times to relapse were 79.8, 70.8, and 70.5 days, respectively. Fluoxetine was associated with some adverse events in 46.3% of patients. The most frequently occurring adverse event was insomnia. CONCLUSION It is proposed that either every third day or daily dosing with the same dose of fluoxetine could treat the patients with major depressive disorder during the acute and continuation period of treatment. Nevertheless, higher daily dose of fluoxetine has a reduced relapse rate compared to that of the lower daily dose.
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Affiliation(s)
- Umit Tural
- Dept. of Psychiatry, Medical School of Kocaeli University, Izmit-Kocaeli, Turkey.
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Abstract
BACKGROUND The aim of this study was to compare the antidepressant efficacy of standard dose, dose optimization of antidepressant drug and buspirone augmentation strategies. METHODS 120 outpatients with a DSM-IV diagnosis of unipolar depression were randomised to 12-weeks of open label treatment with fluoxetine 20 (flx20) or 40 mg (flx40) daily or fluoxetine 20 mg plus buspirone 20 mg daily (flx20-plus-buspirone). The severity of depression was assessed by Hamilton Depression Rating Scale (HDRS). Response was defined as a 50% or greater reduction of the baseline HDRS total score. A response, which began at any time of the study and was maintained until the last visit, was defined as a sustained response. RESULTS The proportion of responders was not significantly different among the treatment groups at the endpoint. Survival analysis showed, however, a significant faster response in the patients treated with flx20 or flx40 alone than flx20-plus-buspirone. The mean times to onset of a sustained response were 33, 24 and 40 days, respectively. LIMITATIONS The lack of treatment-resistant group is a methodological limitation of this study. CONCLUSIONS Adding buspirone to fluoxetine in the treatment of major depressive disorder may delay the time to onset of antidepressant efficacy. In order to accelerate and maximise the clinical response in depressive patients, clinician should prefer to optimize the fluoxetine dose instead of in combination with buspirone.
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Affiliation(s)
- Emin Onder
- Psychiatry Department, Kocaeli University Medical School, Derince, Izmit-Kocaeli 41900, Turkey
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Yildiz M, Emin Onder M, Tural U, Ibrahim Balta H, Koçalim N. [General practitioners' attitudes towards psychotic disorders and their treatment in the primary health care system]. Turk Psikiyatri Derg 2003; 14:106-15. [PMID: 12844277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
OBJECTIVE To assess general practitioners' attitudes and behavior towards psychotic disorders, antipsychotic drug prescriptions, and patients with psychosis in primary health care settings. METHOD 262 general practitioners (GPs) practicing in primary care settings in Kocaeli province were included in the study. The 20-item questionnaire, which was prepared by the researchers, was sent to all GPs via the Kocaeli branch of the Health Ministry. 195 (74.4%) questionnaires were returned. The GPs' responses and the relations between different variables were examined. RESULTS The participation rate among GPs in any education about psychosis and antipsychotic treatment after graduation was 27.2%. The rate seeking structured and advanced education about psychosis was 41.0%. The mean daily number of patients with psychosis examined by GPs in primary care settings during the previous six months was 1.4. They first prescribed any antipsychotic drug by themselves at a rate of 12.8% in the previous six-month. The most frequent reason for antipsychotic prescription was re-prescription (80.0%). The most frequent problem in the pharmacological treatment of psychotic disorders was the drop-out rate of patients (75.9%). The predictors of starting patients with psychosis on medication were the belief that the patients were treatable in primary care and the suspicion of GPs about psychosis. CONCLUSION GPs practicing in primary care settings rarely encounter patients with psychosis. GPs mostly avoid undertaking the responsibility of treating them. However, some are eager to participate in structured education about psychosis in order to have more confidence when diagnosing and treating it.
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Tural U, Fidane H, Alkin T, Bandelow B. Assessing the severity of panic disorder and agoraphobia: validity, reliability and objectivity of the Turkish translation of the Panic and Agoraphobia Scale (P&A). J Anxiety Disord 2003; 16:331-40. [PMID: 12214818 DOI: 10.1016/s0887-6185(02)00104-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of the present study was to determine the psychometric properties of the Turkish translation of both the observer-rated (P&Ao) and self-rated (P&As) versions of the Panic and Agoraphobia Scale (P&A). Discriminant and convergent validity of P&A were assessed in patients with panic disorder with or without agoraphobia (n = 119), by comparing the P&A with the Clinical Global Impression Scale (CGI), Hamilton Anxiety Scale (HAMA), Phobia and Anxiety sub-scales of Symptom Check List, Spielberger State and Trait Anxiety Inventory and the Beck Depression Inventory (BDI). Inter-rater and test-retest reliability were determined. Correlation coefficients between the CGI and the P&Ao and the P&As were .85 and .74, respectively, and .85 between the two versions of the P&A. Cronbach's alpha for the P&Ao, and the P&As was .88 and .86, respectively. The Turkish version of the P&A has yielded good psychometric properties and was found to be a reliable instrument for assessing severity in panic disorder.
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Affiliation(s)
- Umit Tural
- School of Medicine, Dokuz Eylul University, Izmir, Turkey
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Yildiz M, Tural U, Kurdoğlu S, Emin Onder M. [An Experience of a Clubhouse run by Families and Volunteers for Schizophrenia Rehabilitation]. Turk Psikiyatri Derg 2003; 14:281-7. [PMID: 14704930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
OBJECTIVE To test the efficacy of a non-governmental psychosocial rehabilitation program (Psychosocial Rehabilitation Clubhouse), which was developed by the authors and thought to be easy to put into practice for patients with schizophrenia. METHOD Patients with schizophrenia (n: 14) were serviced at "Izmit Our Garden Solidarity Foundation of Families of Patients with Schizophrenia" for 8 months. Rehabilitation services were conducted wholly by families and volunteers, and run by a volunteer psychologist. Program included daily activities, cultural, leisure and social activities, one day in a week. Patients were assessed by using the Quality of Life Scale (QLS), Social Functioning Scale (SFS), Global Assessment Scale (GAS), and Positive and Negative Syndrome Scale (PANNS) at baseline and at the end of the study. RESULTS All patients (n:14) completed the program with 73% mean presence in the activities. Increase of the social functioning and the good clinical outcome was observed in patients. The results of the scales were as follows: SFS at baseline 105.1+/-20.6, in the end 133.7+/-17.1, (p<0.001); GAS at baseline 53.4+/-10.5, in the end 66.0+/-8.1, (p<0.001); QLS at baseline 62.8+/-17.4, in the end 93.4+/-19.8, (p<0.001); and PANSS in the baseline 70.3+/-16.9, in the end 61.9+/-16.5, (p<0.002). CONCLUSION Psychosocial clubhouse rehabilitation program run by patients' families and volunteers in a small foundation environment, which is the first trial in Turkey, has been carried out successfully.
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