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Turan S, Ermiş Ç, Eray Ş, Ağaç N, Karakuş OB, Sağlam Y, Bandırma A, Güler D, Tunçtürk M, Çıray RO, Karaçetin G, İnal N, Üçok A. Illness-related outcomes of illicit substance use disorder in adolescents with early onset schizophrenia: a multicenter study. J Addict Dis 2024:1-5. [PMID: 38566305 DOI: 10.1080/10550887.2024.2332512] [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] [Indexed: 04/04/2024]
Abstract
OBJECTIVES Lifetime co-occurring substance use disorders are common at the time of presentation for the treatment of primary psychosis. Our aim was to investigate the clinical characteristics of adolescents with early-onset schizophrenia/schizoaffective disorder (EOS), categorized as either with (EOS + SUD) or without SUD (non-SUD/EOS), in a multi-center sample. METHODS Between 2016 and 2022, 255 patients were evaluated across three tertiary-care inpatient units. Diagnoses were confirmed by the treating physician according to the DSM-5 during the hospital stay. The severity of symptoms was measured using the Positive and Negative Syndrome Scale (PANSS). RESULTS The EOS + SUD group exhibited a higher illness onset, fewer years of education, longer duration of untreated psychosis (DUP), a higher frequency of male gender, more frequent hospitalizations, increased use of clozapine and zuclopenthixol LAI, along with higher rates of post-traumatic stress disorder and conduct disorder. Notably, differences in DUP, clozapine use, and the number of hospitalizations did not persist in the multivariate logistic regression model. CONCLUSIONS Our findings support the notion of SUD playing a role in modifying the course of illness in EOS. Future studies should emphasize exploring treatment responses to medications and interventions among youth with dual diagnoses.
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Affiliation(s)
- Serkan Turan
- Department of Child and Adolescent Psychiatry, Uludag University School of Medicine, Bursa, Turkey
| | | | - Şafak Eray
- Department of Child and Adolescent Psychiatry, Uludag University School of Medicine, Bursa, Turkey
| | - Nilay Ağaç
- Department of Child and Adolescent Psychiatry, Uludag University School of Medicine, Bursa, Turkey
| | - Oğuz Bilal Karakuş
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Yeşim Sağlam
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Aylin Bandırma
- Department of Child and Adolescent Psychiatry, Uludag University School of Medicine, Bursa, Turkey
| | - Duru Güler
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University School of Medicine, İzmir, Turkey
| | - Mustafa Tunçtürk
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | | | - Gül Karaçetin
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Neslihan İnal
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Alp Üçok
- Department of Psychiatry, Psychotic Disorders Research Program, Istanbul Faculty of Medicine, Istanbul, Turkey
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Sağlam Y, Ermiş Ç, Tunçtürk M, Turan S, Karakuş OB, Alarslan S, Karaçetin G. Neurocognitive and social cognitive impairments in remission and symptomatic states of early-onset schizophrenia spectrum disorders. Eur Child Adolesc Psychiatry 2023; 32:1621-1631. [PMID: 35316416 DOI: 10.1007/s00787-022-01977-w] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 03/11/2022] [Indexed: 11/30/2022]
Abstract
Previous studies demonstrated neurocognitive impairments in early-onset schizophrenia (EOS) and other psychotic spectrum disorders (PSD). This study aimed to compare remitted and symptomatic cases in terms of neurocognition and theory of mind (ToM). 50 healthy controls (HC) and 106 patients diagnosed schizophrenia in remission (EOS-R, n = 38), symptomatic schizophrenia (EOS-S, n = 34), and other PSD (n = 34) were included in our study. The Positive and Negative Symptom Scale, Columbia-Suicide Severity Rating Scale, Reactive and Proactive Aggression Questionnaire were used to evaluate psychopathology. A cognitive battery was conducted to measure verbal learning/memory, visual learning/memory, executive functions (EF), inhibition, processing speed (PS), verbal fluency skills. Reading Mind in Eyes Test (RMET) and Faux-Pas tests were implemented to assess ToM. Principal Component Analysis was used to identify cognitive domain scores. Patient groups had poorer performance in cognitive domains than the HC group. The cognitive impairment and psychopathology levels of EOS-R and the PSD groups were comparable for all cognitive domains. The EOS-S group also had poorer scores in Rey verbal learning score (d = 0.87), RMET (d = 0.72), verbal fluency (d = 0.66), PS/EF (d = 0.82) and visual learning/memory (d = 0.83) test scores than the PSD group. Only RMET (d = 0.72) and executive function/processing speed domain (d = 0.63) were significantly impaired in the EOS-S group than the EOS-R group Cognitive impairments seen in remitted psychotic disorders were on the same continuum. Impaired EF/PS and ToM skills could be a cognitive marker for symptomatic illness in youth.
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Affiliation(s)
- Yeşim Sağlam
- Department of Child and Adolescent Psychiatry, Neurology and Neurosurgery, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Istanbul, Turkey
| | - Çağatay Ermiş
- Department of Child and Adolescent Psychiatry, Diyarbakir Children's Hospital, Diyarbakir, Turkey
| | - Mustafa Tunçtürk
- Department of Child and Adolescent Psychiatry, Neurology and Neurosurgery, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Istanbul, Turkey
| | - Serkan Turan
- Department of Child and Adolescent Psychiatry, Uludag University School of Medicine, 16400, Bursa, Turkey.
| | - Oğuz Bilal Karakuş
- Department of Child and Adolescent Psychiatry, Neurology and Neurosurgery, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Istanbul, Turkey
| | - Sezen Alarslan
- Department of Child and Adolescent Psychiatry, Neurology and Neurosurgery, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Istanbul, Turkey
| | - Gül Karaçetin
- Department of Child and Adolescent Psychiatry, Neurology and Neurosurgery, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Istanbul, Turkey
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Karakuş OB, Ermiş Ç, Tunçtürk M, Yüksel AS, Alarslan S, Sağlam Y, Görmez V, Karaçetin G. Identifying clinical and psychological correlates of persistent negative symptoms in early-onset psychotic disorders. Clin Child Psychol Psychiatry 2022; 27:1288-1302. [PMID: 35227101 DOI: 10.1177/13591045221075531] [Citation(s) in RCA: 4] [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] [Indexed: 01/09/2023]
Abstract
Persistent negative symptoms (PNS) contribute to impairment in psychosis. The characteristics of PNS seen in youth remained under-investigated. We aimed to demonstrate clinical, treatment-related, and psychosocial characteristics of PNS in early-onset schizophrenia-spectrum disorders (EOSD). 132 patients with EOSD were assessed with Positive and Negative Symptom Scale, Brief Negative Symptom Scale, Calgary Depression Scale for Schizophrenia, and Simpson-Angus Scale. Parenting skills and resilience were evaluated using Parental Attitude Research Instrument and Child and Youth Resilience Measure-12. Longer duration of untreated psychosis (DUP) and prodromal phase were found in primary and secondary PNS groups, compared to the non-PNS group. The primary PNS group was characterized by earlier age-onset, lower smoking rates, and more common clozapine use. Resilience and egalitarian/democratic parenting were negatively correlated with symptoms related to motivation/pleasure and blunted expression. More blunted expression-related symptoms and longer DUP in the first episode significantly predicted primary/secondary PNS at follow-up. Using the data from total negative symptom scores and DUP, Receiver Operating Characteristic analyses significantly differentiated primary/secondary PNS groups from the non-PNS counterparts. PNS associated with blunted expression and low motivation/pleasure in the first episode could persist into clinical follow-up. Effective pharmacological treatment and psychosocial interventions are needed in youth.
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Affiliation(s)
- Oğuz Bilal Karakuş
- Department of Child and Adolescent Psychiatry, 147007University of Health Sciences, Istanbul Erenkoy Mental Health and Neurological Diseases Training and Research Hospital, Istanbul, Turkey
| | - Çağatay Ermiş
- Department of Child and Adolescent Psychiatry, Diyarbakir Children's Hospital, Diyarbakir, Turkey
| | - Mustafa Tunçtürk
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Ayşe Sena Yüksel
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Sezen Alarslan
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Yeşim Sağlam
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Vahdet Görmez
- Faculty of Medicine, Department of Child and Adolescent PsychiatryIstanbul Medeniyet University, Istanbul, Turkey
| | - Gül Karaçetin
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Bakirkoy Prof Dr Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
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Abstract
In this study, we investigated the body image of Turkish women in their first year postpartum. We recruited 440 postpartum women who had applied to the outpatient clinics of the Maternity and Children's Hospital in the city of Ordu, Turkey. The mean of the women's body image scores was over the "middle level." The women's body image scale (BIS) score showed a significant negative relation with age, number of births, weight before pregnancy, weight gain, during pregnancy, weight soon after childbirth, present weight, postpartum weight gain, and postpartum body mass index (BMI).
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Affiliation(s)
- Nülüfer Erbil
- Department of Nursing, School of Health, Ordu University, Turkey.
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Ogur Beyazyurek C, Sağlam Y, Sertyel S, Karlikaya G, Isin S, Kahraman S. P-937. Fertil Steril 2006. [DOI: 10.1016/j.fertnstert.2006.07.1330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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