Serkut Bulut - Academia.edu (original) (raw)
Papers by Serkut Bulut
Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry, 2014
Özet Obsesif kompulsif bozukluk ileri derecede yeti yitimine neden olabilen ruhsal bir bozukluktu... more Özet Obsesif kompulsif bozukluk ileri derecede yeti yitimine neden olabilen ruhsal bir bozukluktur. OKB hastalarında içgörü hastalığın ilk tanımlanmasından bu yana tartışma konusudur. Önceleri, nörotik bozukluklardan biri olarak kabul edilen obsesif kompulsif bozuklukta hastaların belirtilerini tamamen saçma ve abartılı bulmaları gerektiği düşünülmüştür. Ancak, obsesyonların ve kompulsiyonların her zaman egodistonik bulunacağı fikri giderek değişmiştir. İlk olarak Ruhsal Bozuklukların Tanısal ve Sayımsal El Kitabının 4. Baskısında (DSM-IV)'te obsesif kompulsif bozuklukta "içgörüsü az olan" ifadesine yer verilmiştir. İçgörüsü az olan ya da olmayan obsesif kompulsif bozukluğun içgörünün korunduğu obsesif kompulsif bozukluktan sosyodemografik, klinik ve tedavi özellikleri bakımından farklılıkları olabilir. Obsesif kompulsif bozuklukta belirti tiplerine göre içgörü düzeyleri değişebilmektedir. İçgörüsü az obsesif kompulsif bozukluk, obsesif kompulsif bozukluğun şiddetli bir formu ya da farklı özellikler gösteren bir alt tip olabilir. DSM-5 ile birlikte içgörü belirteci sınıflandırmadan çıkarılmıştır. Obsesif kompulsif bozukluk hastalarının içgörülerinin bir yelpaze ya da süreklilik şeklinde ele alınması gerekir.
Balkan Medical Journal, Sep 30, 2020
Content of this journal is licensed under a Creative Commons Attribution-NonCommercial-NoDerivati... more Content of this journal is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. Background: Approximately half of the children with attention-deficit hyperactivity disorder continue to meet diagnostic criteria in adulthood. The prevalence of adult attention-deficit hyperactivity disorder is reported between 2.5% and 4.4% and is associated with significant impairment in quality of life and increased psychiatric comorbidity. Attention-deficit hyperactivity disorder in adults remains mostly undiagnosed and/or untreated despite the availability of effective treatments. The majority of people who do not receive necessary treatment are in the nonclinical or nonpsychiatric clinical population. Screening is an important step for diagnosing adults with attention-deficit hyperactivity disorder. Yet, there are no valid and reliable screening questionnaires calibrated for the Diagnostic and Statistical Manual for Mental Disorders-5 in Turkish. Aims: We aimed to test the reliability and the validity of the Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 screening questionnaire designed according to DSM-5 in the Turkish population. Study Design: Methodological and cross-sectional study. Methods: The translation was carried out according to the World Health Organization Composite International Diagnostic Interview translation guide using a linguistic adaptation approach. We used a convenience sampling method to recruit an individual with adult attention-deficit hyperactivity disorder (n = 68) and a control group (n = 68). The participants completed a sociodemographic form, 6-items Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5, and the previous version 18-items Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1 for the concurrent validity analysis. For the diagnostic validity, clinical diagnosis made by psychiatrists according to the Diagnostic and Statistical Manual for Mental Disorders-5 criteria was used. Internal consistency and item-total correlation coefficients, exploratory factor analyses, correlation with Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1, and receiver operating characteristic curve analysis were conducted. Results: The internal consistency measured by Cronbach alpha was 0.869. Item-total correlation coefficients were calculated to be between 0.602 and 0.717, and the correlations were statistically significant (P < 0.0001). The Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 showed to have a unidimensional factor structure explaining 60.54% of the variance. The correlation between Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 and Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1 total score was calculated as 0.992 (P < 0.0001), and that between Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 and Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1 attention-deficit subdimension was 0.868 (P < 0.0001). In the receiver operating characteristic analysis of Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5, the area under the curve was found to be 0.916. The cutoff score was calculated as 9 of 10 with a sensitivity of 85.2% and specificity of 89.7%. Conclusion: Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 is a valid and reliable self-report measure to assess and screen attention-deficit hyperactivity disorder in the Turkish population. It may be useful for both clinical and population studies.
Özet Obsesif kompulsif bozukluk ileri derecede yeti yitimine neden olabilen ruhsal bir bozukluktu... more Özet Obsesif kompulsif bozukluk ileri derecede yeti yitimine neden olabilen ruhsal bir bozukluktur. OKB hastalarında içgörü hastalığın ilk tanımlanmasından bu yana tartışma konusudur. Önceleri, nörotik bozukluklardan biri olarak kabul edilen obsesif kompulsif bozuklukta hastaların belirtilerini tamamen saçma ve abartılı bulmaları gerektiği düşünülmüştür. Ancak, obsesyonların ve kompulsiyonların her zaman egodistonik bulunacağı fikri giderek değişmiştir. İlk olarak Ruhsal Bozuklukların Tanısal ve Sayımsal El Kitabının 4. Baskısında (DSM-IV)'te obsesif kompulsif bozuklukta "içgörüsü az olan" ifadesine yer verilmiştir. İçgörüsü az olan ya da olmayan obsesif kompulsif bozukluğun içgörünün korunduğu obsesif kompulsif bozukluktan sosyodemografik, klinik ve tedavi özellikleri bakımından farklılıkları olabilir. Obsesif kompulsif bozuklukta belirti tiplerine göre içgörü düzeyleri değişebilmektedir. İçgörüsü az obsesif kompulsif bozukluk, obsesif kompulsif bozukluğun şiddetli bir formu ya da farklı özellikler gösteren bir alt tip olabilir. DSM-5 ile birlikte içgörü belirteci sınıflandırmadan çıkarılmıştır. Obsesif kompulsif bozukluk hastalarının içgörülerinin bir yelpaze ya da süreklilik şeklinde ele alınması gerekir.
Journal of Surgery and Medicine
How to cite: Bulut NS, Yorguner N. Analysis of the psychiatric consultations requested for hospit... more How to cite: Bulut NS, Yorguner N. Analysis of the psychiatric consultations requested for hospitalized COVID-19 patients: One year results from a major pandemic hospital.
The seductive allure effect extends from neuroscientific to psychoanalytic explanations among Turkish medical students: preliminary implications of biased scientific reasoning within the context of medical and psychiatric training
Thinking & Reasoning
Bu tez çalışmasında, bilinçli algı oluşturan ve oluşturmayan görsel uyaranların emosyonel işlemle... more Bu tez çalışmasında, bilinçli algı oluşturan ve oluşturmayan görsel uyaranların emosyonel işlemlenme süreçlerinin incelenmesi ve kognitif tekniklerin emosyonun düzenlenmesi üzerindeki etkilerinin objektif yöntemlerle ortaya konması amaçlanmıştır. Bu doğrultuda, örneklemleri, kronoloji ve metodojileri itibariyle birbirinden farklı ancak hipotetik temelleri itibariyle birbirini destekleyen üç ayrı çalışma yürütülmüştür. ÇALIŞMA NO 1 Dar tanımıyla, emosyonel bir yanıtın oluşumu ve bu yanıtın etkin biçimde kontrol altına alınması aşamalarını içeren emosyon regülasyonunun nesnel yöntemlerle tespiti oldukça zordur. Son dönem görüntüleme çalışmaları, kognitif tekniklerin uygulanması esnasında aktive olan üst kortikal devrelerin, amigdala merkezli korku yanıtının kontrol altına alınmasında önemli rol oynadığına işaret etmektedir. Bu çalışmada ilk olarak, emosyon regülasyonunun tespitinde oldukça yeni ve özelleşmiş bir psikofizyolojik parametre olarak öne sürülen 0,1 Hz Kalp Atım Hızı Değişk...
An Analysis of the Psychosocial Challenges Faced by the University Students During COVID-19 Pandemic, and the Students’ Knowledge, Attitudes, and Practices Toward the Disease
Archives of Neuropsychiatry, 2021
Introduction The aims of the present study were 1) to identify the major psychosocial challenges ... more Introduction The aims of the present study were 1) to identify the major psychosocial challenges faced by students of a university in Istanbul, during the initial period of the COVID-19 outbreak, 2) to assess how these interacted with their level of knowledge, attitudes, and practices toward COVID-19 and the related health measures in place. Methods As part of an international research, a total of 2583 university students from Istanbul participated in an online survey, which included questions in several domains including their studies and daily life before and after the outbreak, their concerns and worries about the pandemic, their level of knowledge on COVID-19, their views on the policies implemented by the government and their institution, their attitude and practices toward the protective measures. Results Majority of the students reported to suffer from financial adversities due to the outbreak. The closure of residential facilities and the cancellation of face-to-face lectures resulted in the vast majority of the students moving back to their family home. Their daily routines were largely replaced by individual home activities, and social interactions shifted almost totally to digital platforms. They also reported high levels of anxiety and worries concerning a wide range of the possible detrimental outcomes of COVID-19, which were in close association with their knowledge, attitudes, and practices towards the disease, as well as their adherence to the policy measures and their satisfaction with the policies of the government. Conclusion These results may help policymakers in better understanding the psychosocial impacts of COVID-19 on the life of university students, and to develop more comprehensive strategies to address their multifaceted struggles, as well as to improve their compliance with the health measures in the future.
ALPHA PSYCHIATRY, 2021
Objective: This study aimed to draw a general picture of the impact of the coronavirus disease 20... more Objective: This study aimed to draw a general picture of the impact of the coronavirus disease 2019 (COVID-19) pandemic on the life of higher-education students in İstanbul, with specific emphasis on the relationship between students' social support systems, healthrisk behaviors, and mental/academic well-being. Methods: A total of 2583 higher-education students from different fields of study participated in an online survey gathering information from several domains, including available social networks, support-seeking attitudes, substance use patterns, physical activity levels, academic stress, academic satisfaction, and psychological well-being during the pandemic. Results: Our findings pointed to major changes in students' life circumstances and daily routines during COVID-19, including a significant decrease in contact with friends, overall substance use, and physical activity as well as high levels of depression, academic stress, and academic dissatisfaction. Depressive symptoms were significantly predicted by the loneliness score (OR = 2.08, 95% CI = 1.88-2.29), female gender (OR = 1.65, 95% CI = 1.21-2.24), frequency of binge drinking (OR = 1.4, 95% CI = 1.06-1.86), and level of academic stress (OR = 1.15, 95% CI = 1.1-1.19), whereas the number of people to easily borrow money from was found to be a protective factor against depression (OR = 0.95, 95% CI = 0.92-0.99). Conclusion: Our results highlight the need for higher-education institutions to take the appropriate social and mental health interventions, tailored to fit the specific requirements of the COVID-19-related measures.
Marmara Medical Journal, 2022
How to cite this article: Bulut NS, Yorguner N. Comparison of the intensity of peripheral inflamm... more How to cite this article: Bulut NS, Yorguner N. Comparison of the intensity of peripheral inflammation between major depressive disorder and bipolar depression by means of neutrophil-lymphocyte and platelet-lymphocyte ratios: The possible role of clinical severity and psychotic features.
Turk psikiyatri dergisi = Turkish journal of psychiatry, 2021
Functional (psychogenic) movement disorders (FMD) constitute a cluster of heterogeneous diagnoses... more Functional (psychogenic) movement disorders (FMD) constitute a cluster of heterogeneous diagnoses involving motor symptoms that cannot be explained by organic pathology and are often associated with underlying psychological problems. In psychiatry, patients with FMD are often placed within the scope of somatoform disorders and conversion disorders. Functional Parkinsonism (FP) is a rare form of FMD seen in 1.5% of all patients presenting with symptoms of parkinsonism. Although almost all symptoms of parkinsonism can be present in FP, clinical features such as sudden onset and a nonprogressive course, inconsistent response to pharmacotherapy, and atypical findings in neurological examination are considered as important clues of psychogenic aetiology. Limited data in the literature on FP indicate that the average age of onset is between 37-53 years of age, whereas the average onset age of Idiopathic Parkinson's Disease (IPD) is around 60; and Juvenile Parkinsonism, a rare conditio...
The severity of inflammation in major neuropsychiatric disorders: comparison of neutrophil–lymphocyte and platelet–lymphocyte ratios between schizophrenia, bipolar mania, bipolar depression, major depressive disorder, and obsessive compulsive disorder
Nordic Journal of Psychiatry, 2021
Abstract Background As non-specific markers of immune dysregulation, neutrophil–lymphocyte and pl... more Abstract Background As non-specific markers of immune dysregulation, neutrophil–lymphocyte and platelet–lymphocyte ratios (NLR and PLR) have been consistently shown to be increased in major neuropsychiatric disorders. Although this increase seems to be trans-diagnostic, the extent to which its magnitude differs between disorders remains largely unclear. Aim The aim of this study was to directly compare the severity of inflammation (as reflected by NLR and PLR) between schizophrenia (Sch), bipolar mania (BD-M), bipolar depression (BD-D), major depressive disorder (MDD) and obsessive compulsive disorder (OCD). Methods NLR and PLR were obtained for a total of 417 subjects (91 Sch, 70 BD-D, 37 BD-M, 93 MDD, 37 OCD, and 95 controls) and analyzed for group differences. Results Sch, BD-M, BD-D and MDD presented with significantly higher NLR compared with both OCD and HC. NLR in BD-M was significantly higher than all the remaining groups, whereas Sch, BD-D and MDD presented with comparably elevated NLR. Moreover, BD-M, Sch and MDD had significantly higher PLR compared with HC. Conclusion These results suggest that the underlying inflammation may be most severe in BD-M, followed by Sch, BD-D and MDD. On the other hand, inflammation may be of negligible intensity in OCD, or at least undetectable by means of NLR or PLR.
Acute onset psychosis with complex neurobehavioural symptomatology following the intramuscular injection of hyoscine butylbromide: a case report with an overview of the literature
European Journal of Hospital Pharmacy, 2020
Different compounds of hyoscine (scopolamine) are widely used for the treatment of a variety of c... more Different compounds of hyoscine (scopolamine) are widely used for the treatment of a variety of conditions, ranging from motion sickness to colic spasms and smoking cessation. In some rare conditions, the administration of scopolamine may lead to severe idiosyncratic reactions, including central anticholinergic intoxication syndrome. Here, we present a young female patient who progressively developed a series of complex neuropsychiatric symptoms including ataxia, slurred and rambling speech, stereotypic movements, vivid visual and auditory hallucinations, and self-mutilative behaviours in the days following the injection of hyoscine butylbromide in the emergency room to treat her menstrual cramps. Referred to psychiatry, detailed screening of her medical records and collateral information from the family revealed that the neurobehavioural manifestations were indeed preceded by severe peripheral anticholinergic toxicity, which were mostly overlooked during the initial evaluations. Started on olanzapine treatment, the patient’s symptoms gradually subsided over time, though it took several weeks to achieve full clinical recovery.
Balkan Medical Journal, 2020
Content of this journal is licensed under a Creative Commons Attribution-NonCommercial-NoDerivati... more Content of this journal is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. Background: Approximately half of the children with attention-deficit hyperactivity disorder continue to meet diagnostic criteria in adulthood. The prevalence of adult attention-deficit hyperactivity disorder is reported between 2.5% and 4.4% and is associated with significant impairment in quality of life and increased psychiatric comorbidity. Attention-deficit hyperactivity disorder in adults remains mostly undiagnosed and/or untreated despite the availability of effective treatments. The majority of people who do not receive necessary treatment are in the nonclinical or nonpsychiatric clinical population. Screening is an important step for diagnosing adults with attention-deficit hyperactivity disorder. Yet, there are no valid and reliable screening questionnaires calibrated for the Diagnostic and Statistical Manual for Mental Disorders-5 in Turkish. Aims: We aimed to test the reliability and the validity of the Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 screening questionnaire designed according to DSM-5 in the Turkish population. Study Design: Methodological and cross-sectional study. Methods: The translation was carried out according to the World Health Organization Composite International Diagnostic Interview translation guide using a linguistic adaptation approach. We used a convenience sampling method to recruit an individual with adult attention-deficit hyperactivity disorder (n = 68) and a control group (n = 68). The participants completed a sociodemographic form, 6-items Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5, and the previous version 18-items Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1 for the concurrent validity analysis. For the diagnostic validity, clinical diagnosis made by psychiatrists according to the Diagnostic and Statistical Manual for Mental Disorders-5 criteria was used. Internal consistency and item-total correlation coefficients, exploratory factor analyses, correlation with Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1, and receiver operating characteristic curve analysis were conducted. Results: The internal consistency measured by Cronbach alpha was 0.869. Item-total correlation coefficients were calculated to be between 0.602 and 0.717, and the correlations were statistically significant (P < 0.0001). The Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 showed to have a unidimensional factor structure explaining 60.54% of the variance. The correlation between Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 and Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1 total score was calculated as 0.992 (P < 0.0001), and that between Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 and Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1 attention-deficit subdimension was 0.868 (P < 0.0001). In the receiver operating characteristic analysis of Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5, the area under the curve was found to be 0.916. The cutoff score was calculated as 9 of 10 with a sensitivity of 85.2% and specificity of 89.7%. Conclusion: Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 is a valid and reliable self-report measure to assess and screen attention-deficit hyperactivity disorder in the Turkish population. It may be useful for both clinical and population studies.
Psychiatry and Clinical Psychopharmacology, 2018
OBJECTIVE: Children and adolescents facing difficult life circumstances due to social, economic a... more OBJECTIVE: Children and adolescents facing difficult life circumstances due to social, economic and cultural adversity, form a disadvantaged group in terms of social functioning and healthy psycho-social development. The goal of this study was to evaluate the psychological resilience of high school students in Muş Citywhich was ranked last in the general life index among 81 provinces according to 2015 data from the Turkish Statistical Instituteand to examine different dimensions of psychological resilience in relation to a variety of variables including adverse life events and demographic characteristics. METHOD: The study sample consisted of 1025 students from the 10th and 11th grades of five different high schools operating in the city centre of Muş. Participants were asked to fill in a socio-demographic questionnaire, the List of Adverse Life Events and the 59-item Resilience and Youth Development Module (RYDM). A series of correlational and descriptive analyses were then performed. RESULTS: Correlational analyses revealed that among the demographic factors, low economic status, a criminal record and poor academic performance were associated with poor psychological resilience, while among adverse life events, the deterioration of parental economic status, frequent arguments between parents as well as a history of mental illness and alcohol/substance abuse in the family were also linked to low levels of psychological resilience. It was also determined that girls had higher scores on internal assets of RYDM (empathy, problem solving, self efficacy, communication and cooperation, goals, self awareness and educational aspirations), while exposure to a larger number of adverse life events negatively affected internal resilience assets. Finally, trauma exposure, just as the low RYDM scores, seems to be associated with frequent arguments between parents, alcohol/ substance abuse in the family, male gender and a criminal record. However, there was no significant relationship between psychological resilience and trauma alone. CONCLUSION: Interventions to improve psychological resilience, which is a dynamic process, need to be comprehensive and multi-dimensional. In this context, it is crucial to elucidate the factors associated with the psychological resilience of children and adolescents exposed to a specific risk factor, such as adverse living conditions. In order to improve our understanding of psychological resilience and youth development in Turkey and to determine specific needs for interventions, future studies on various risk groups in different pilot citiesas in the example of Muşare needed.
Psychiatry Research, 2018
For 30 years, bright light therapy (BLT) has been considered as an effective, well-tolerated trea... more For 30 years, bright light therapy (BLT) has been considered as an effective, well-tolerated treatment for seasonal affective disorder (SAD). Because of low response rates, new treatment strategies are needed for bipolar depression (BD), which resembles SAD in certain respects. Few placebo-controlled studies of BLT efficacy have been carried out for BD. Accordingly, this study evaluates the efficacy and safety of BLT as an add-on treatment for BD. Thirty-two BD outpatients were randomly assigned to BLT (10000 lux) or dim light (DL, <500 lux). During a two-week period, light was administered each morning for 30 min. The Hamilton Rating Scale for Depression and the Montgomery-Ǻsberg Depression Rating Scale assessed clinical outcome, and the UKU Side Effects Rating Scale evaluated side effects. No significant difference was observed in baseline
International Journal of Psychophysiology, 2018
Previous research has increased understanding of the neurobiological basis of emotional regulatio... more Previous research has increased understanding of the neurobiological basis of emotional regulation. However, less is known concerning the unconscious processing of affective information. Three experiments were performed to investigate the extent to which complex affective stimuli can be processed outside of consciousness and demonstrate possible mechanisms for regulation of resulting emotional responses. In Experiment 1, participants were either instructed to passively observe blocked-picture cues (neutral and negative) or to downregulate their emotions by distancing. Resulting emotional regulation activity was assessed with 0.1-Hz heart rate variability (HRV) indices. In Experiment 2, participants were presented with affective pictures that were rendered consciously invisible by means of continuous flash suppression (CFS). In Experiment 3, two equivalent sets of negative affective pictures were covertly presented and the effect of a cognitive task on emotional regulation was evaluated. Our findings revealed that 0.1-Hz HRV indices exhibited greater change over baseline in response to negative compared to neutral stimuli for both presentation conditions (consciously perceived or not). The implementation of distancing and the cognitive task were both associated with higher 0.1-Hz HRV change scores. These results indicate that even complex affective stimuli can be processed without awareness, resulting in a congruent emotional response that is physiologically detectable. Cognitive strategies can help more effectively regulate this response, implying that conscious perception of a triggering stimulus may not be essential for cognitive regulation.
Psychiatry and Clinical Psychopharmacology, 2018
Objective: It has been proposed that anything does not kill you make you stronger. Although it mi... more Objective: It has been proposed that anything does not kill you make you stronger. Although it might be true in adult cases, children whose psychological life begin in the parental mind and shaped by the experiences during the early period of life are not as strong as adult against adverse effects of stressful events. Internalization of objects and emerging of internally working models, concept of normality and abnormality that will be the main ground for the understanding of the world in later life are emerged during childhood. That is why anything does not kill a child will shape its mind that might have everlasting effects on child.
Psychiatry and Clinical Psychopharmacology, 2018
Grief mania that is evaluated as psychogenic mania in the literature is related to manic episode ... more Grief mania that is evaluated as psychogenic mania in the literature is related to manic episode that emerges after the loss of a loved one. There are not many cases that associate causality of beginning of mania and mourning in the literature. It is known that mania is induced by traumatic events but the cases that do not suit stages of development of grief process are evaluated as pathological grief. In this case, the woman who experienced manic episode after her son's death is presented. This case is prepared because mania should be considered as possible grief reaction. Case presentation: A patient who is 40 years old, married, mother of 4 children is brought by relatives because of aggressiveness, tension, insomnia for 4 days, fast and talk a lot and nonsense laughing attacks. She was presented to hospital for stressful life events 2 years ago and started to be on medication (escitalopram 10 mg) because of depression and fibromiyaliji diagnosis. She used medication for 1.5 years and she did not use any medication for the last 6months. There is no history for mental disorder in her family. Psychological examination: her interest for the environment was increased, self-care ability got better, her temperament was cheerful, her sociability was respectful, amount of talking and tone of voice increased, mimic and gesture was appropriate for her temperament, sleeping decreased, thought flow increased and achieved goal of conversation late. Moreover, there were grandiose delusions and hypervigilance, affect was close to euphoria, her psychomotor behaviours increased and social functioning decreased. According to biochemical and radiological workup, there was no pathological situation. The client started to use Lithium 900 mg/day and Olanzapin 10 mg/day because of the bipolar disorder diagnosis. The patient's blood lithium level was 0.8mEq/L and lithium was used 1200 mg/day and then 10 days later the patient's blood lithium level was 0.72 mEq/L. According to clinical observations, the patient's manic symptoms remained. Furthermore, the patient started to cry occasionally after 1 month and her grandiosity disappeared. The patient was discharged from the hospital after 45 days. The patient met the criteria for manic episode in DSM 5. The patient did not take any medication for last 6 months. Thus, it is considered that this situation was not induced by medication. It puts the patient into risk group because she was treated for depression before but it is not considered as bipolar depression because there were psychiatric history in the family and depression that experienced 2 years ago was related to stressful life events. It is considered that this case experienced grief/funeral mania because there was contiguity between loss of her son and manic episode, the patient did not react this way to previous challenging life events and the patient was outside of the ordinary 5 stages of grief process.
Noro Psikiyatri Arsivi, 2016
Objective: Domestic violence (DV) is defined as all kinds of abusive behaviors between spouses or... more Objective: Domestic violence (DV) is defined as all kinds of abusive behaviors between spouses or relatives living in the same house. Domestic violence is most commonly directed towards women and children. This study aims to review the extent of domestic violence among women consulting to psychiatric outpatient clinic, and to identify its relation with sociodemographic risk factors and psychological symptoms. Method: Self-reported Domestic Violence Questionnaire and Symptom Checklist-90-R (SCL-90-R) information was collected from women who admitted to psychiatric outpatient clinic at Marmara University Research and Educational Hospital, and accepted to participate in the study. Results: 300 women participated in the study. Mean age of participants was 36.24±10.88, 75.7% of them were married, and mostly live within nuclear families. 70.1% of the participants reported verbal violence, and 49.0% reported physical violence. 65.3% of those who have experienced verbal violence have also experienced physical violence. 26.1% of them reported as not having experienced domestic violence before. The nature and extent of domestic violence, women's attitudes towards it, and its relation with experience of domestic violence during childhood have been explored. Participants' educational levels, current age and age of marriage, style of marriage, educational level and age of spouse were not found to be associated with experiencing of domestic violence. Both verbal and physical domestic violence were significantly associated with the economic status of women (p<0.05). The mean SCL-90-R score was 1.40±0.68 with the highest mean subgroup score under depressive symptoms category (1.80±0.79). Mean SCL-90-R score showed significant association with the experience of domestic violence (p≤0.001). Conclusion: Most of the women participated in the study have experienced domestic violence. Both verbal and physical violence increased with lower economic status. Psychiatric symptoms increased with the experience of domestic violence. Considering its high prevalence and detrimental psychological effects, domestic violence should be inquired by clinicians as part of the psychiatric interview.
Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry, 2017
Öz Yüksek morbidite ve mortalitesine karşın anoreksiya nervozanın psikolojik tedavilerine yönelik... more Öz Yüksek morbidite ve mortalitesine karşın anoreksiya nervozanın psikolojik tedavilerine yönelik araştırmalar sınırlı sayıdadır. Bu yazıda, anoreksiya nervozaya yönelik çeşitli psikososyal tedavi yöntemlerinin genel hatlarıyla tanıtılması ve bu yöntemlerin etkinliklerine dair randomize kontrollü çalışmaların güncel bir derlemesinin yapılması amaçlanmıştır. Derlenen araştırmalar, ergenler üzerinde yürütülen çalışmalar ve ergenlerle erişkinlerin birlikte olduğu çalışmalar olmak üzere iki ana başlık altında incelenmiş; diğer değişkenlerle ilgili hususlar ayrıca ele alınmıştır.
Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry, 2014
Özet Obsesif kompulsif bozukluk ileri derecede yeti yitimine neden olabilen ruhsal bir bozukluktu... more Özet Obsesif kompulsif bozukluk ileri derecede yeti yitimine neden olabilen ruhsal bir bozukluktur. OKB hastalarında içgörü hastalığın ilk tanımlanmasından bu yana tartışma konusudur. Önceleri, nörotik bozukluklardan biri olarak kabul edilen obsesif kompulsif bozuklukta hastaların belirtilerini tamamen saçma ve abartılı bulmaları gerektiği düşünülmüştür. Ancak, obsesyonların ve kompulsiyonların her zaman egodistonik bulunacağı fikri giderek değişmiştir. İlk olarak Ruhsal Bozuklukların Tanısal ve Sayımsal El Kitabının 4. Baskısında (DSM-IV)'te obsesif kompulsif bozuklukta "içgörüsü az olan" ifadesine yer verilmiştir. İçgörüsü az olan ya da olmayan obsesif kompulsif bozukluğun içgörünün korunduğu obsesif kompulsif bozukluktan sosyodemografik, klinik ve tedavi özellikleri bakımından farklılıkları olabilir. Obsesif kompulsif bozuklukta belirti tiplerine göre içgörü düzeyleri değişebilmektedir. İçgörüsü az obsesif kompulsif bozukluk, obsesif kompulsif bozukluğun şiddetli bir formu ya da farklı özellikler gösteren bir alt tip olabilir. DSM-5 ile birlikte içgörü belirteci sınıflandırmadan çıkarılmıştır. Obsesif kompulsif bozukluk hastalarının içgörülerinin bir yelpaze ya da süreklilik şeklinde ele alınması gerekir.
Balkan Medical Journal, Sep 30, 2020
Content of this journal is licensed under a Creative Commons Attribution-NonCommercial-NoDerivati... more Content of this journal is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. Background: Approximately half of the children with attention-deficit hyperactivity disorder continue to meet diagnostic criteria in adulthood. The prevalence of adult attention-deficit hyperactivity disorder is reported between 2.5% and 4.4% and is associated with significant impairment in quality of life and increased psychiatric comorbidity. Attention-deficit hyperactivity disorder in adults remains mostly undiagnosed and/or untreated despite the availability of effective treatments. The majority of people who do not receive necessary treatment are in the nonclinical or nonpsychiatric clinical population. Screening is an important step for diagnosing adults with attention-deficit hyperactivity disorder. Yet, there are no valid and reliable screening questionnaires calibrated for the Diagnostic and Statistical Manual for Mental Disorders-5 in Turkish. Aims: We aimed to test the reliability and the validity of the Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 screening questionnaire designed according to DSM-5 in the Turkish population. Study Design: Methodological and cross-sectional study. Methods: The translation was carried out according to the World Health Organization Composite International Diagnostic Interview translation guide using a linguistic adaptation approach. We used a convenience sampling method to recruit an individual with adult attention-deficit hyperactivity disorder (n = 68) and a control group (n = 68). The participants completed a sociodemographic form, 6-items Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5, and the previous version 18-items Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1 for the concurrent validity analysis. For the diagnostic validity, clinical diagnosis made by psychiatrists according to the Diagnostic and Statistical Manual for Mental Disorders-5 criteria was used. Internal consistency and item-total correlation coefficients, exploratory factor analyses, correlation with Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1, and receiver operating characteristic curve analysis were conducted. Results: The internal consistency measured by Cronbach alpha was 0.869. Item-total correlation coefficients were calculated to be between 0.602 and 0.717, and the correlations were statistically significant (P < 0.0001). The Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 showed to have a unidimensional factor structure explaining 60.54% of the variance. The correlation between Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 and Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1 total score was calculated as 0.992 (P < 0.0001), and that between Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 and Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1 attention-deficit subdimension was 0.868 (P < 0.0001). In the receiver operating characteristic analysis of Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5, the area under the curve was found to be 0.916. The cutoff score was calculated as 9 of 10 with a sensitivity of 85.2% and specificity of 89.7%. Conclusion: Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 is a valid and reliable self-report measure to assess and screen attention-deficit hyperactivity disorder in the Turkish population. It may be useful for both clinical and population studies.
Özet Obsesif kompulsif bozukluk ileri derecede yeti yitimine neden olabilen ruhsal bir bozukluktu... more Özet Obsesif kompulsif bozukluk ileri derecede yeti yitimine neden olabilen ruhsal bir bozukluktur. OKB hastalarında içgörü hastalığın ilk tanımlanmasından bu yana tartışma konusudur. Önceleri, nörotik bozukluklardan biri olarak kabul edilen obsesif kompulsif bozuklukta hastaların belirtilerini tamamen saçma ve abartılı bulmaları gerektiği düşünülmüştür. Ancak, obsesyonların ve kompulsiyonların her zaman egodistonik bulunacağı fikri giderek değişmiştir. İlk olarak Ruhsal Bozuklukların Tanısal ve Sayımsal El Kitabının 4. Baskısında (DSM-IV)'te obsesif kompulsif bozuklukta "içgörüsü az olan" ifadesine yer verilmiştir. İçgörüsü az olan ya da olmayan obsesif kompulsif bozukluğun içgörünün korunduğu obsesif kompulsif bozukluktan sosyodemografik, klinik ve tedavi özellikleri bakımından farklılıkları olabilir. Obsesif kompulsif bozuklukta belirti tiplerine göre içgörü düzeyleri değişebilmektedir. İçgörüsü az obsesif kompulsif bozukluk, obsesif kompulsif bozukluğun şiddetli bir formu ya da farklı özellikler gösteren bir alt tip olabilir. DSM-5 ile birlikte içgörü belirteci sınıflandırmadan çıkarılmıştır. Obsesif kompulsif bozukluk hastalarının içgörülerinin bir yelpaze ya da süreklilik şeklinde ele alınması gerekir.
Journal of Surgery and Medicine
How to cite: Bulut NS, Yorguner N. Analysis of the psychiatric consultations requested for hospit... more How to cite: Bulut NS, Yorguner N. Analysis of the psychiatric consultations requested for hospitalized COVID-19 patients: One year results from a major pandemic hospital.
The seductive allure effect extends from neuroscientific to psychoanalytic explanations among Turkish medical students: preliminary implications of biased scientific reasoning within the context of medical and psychiatric training
Thinking & Reasoning
Bu tez çalışmasında, bilinçli algı oluşturan ve oluşturmayan görsel uyaranların emosyonel işlemle... more Bu tez çalışmasında, bilinçli algı oluşturan ve oluşturmayan görsel uyaranların emosyonel işlemlenme süreçlerinin incelenmesi ve kognitif tekniklerin emosyonun düzenlenmesi üzerindeki etkilerinin objektif yöntemlerle ortaya konması amaçlanmıştır. Bu doğrultuda, örneklemleri, kronoloji ve metodojileri itibariyle birbirinden farklı ancak hipotetik temelleri itibariyle birbirini destekleyen üç ayrı çalışma yürütülmüştür. ÇALIŞMA NO 1 Dar tanımıyla, emosyonel bir yanıtın oluşumu ve bu yanıtın etkin biçimde kontrol altına alınması aşamalarını içeren emosyon regülasyonunun nesnel yöntemlerle tespiti oldukça zordur. Son dönem görüntüleme çalışmaları, kognitif tekniklerin uygulanması esnasında aktive olan üst kortikal devrelerin, amigdala merkezli korku yanıtının kontrol altına alınmasında önemli rol oynadığına işaret etmektedir. Bu çalışmada ilk olarak, emosyon regülasyonunun tespitinde oldukça yeni ve özelleşmiş bir psikofizyolojik parametre olarak öne sürülen 0,1 Hz Kalp Atım Hızı Değişk...
An Analysis of the Psychosocial Challenges Faced by the University Students During COVID-19 Pandemic, and the Students’ Knowledge, Attitudes, and Practices Toward the Disease
Archives of Neuropsychiatry, 2021
Introduction The aims of the present study were 1) to identify the major psychosocial challenges ... more Introduction The aims of the present study were 1) to identify the major psychosocial challenges faced by students of a university in Istanbul, during the initial period of the COVID-19 outbreak, 2) to assess how these interacted with their level of knowledge, attitudes, and practices toward COVID-19 and the related health measures in place. Methods As part of an international research, a total of 2583 university students from Istanbul participated in an online survey, which included questions in several domains including their studies and daily life before and after the outbreak, their concerns and worries about the pandemic, their level of knowledge on COVID-19, their views on the policies implemented by the government and their institution, their attitude and practices toward the protective measures. Results Majority of the students reported to suffer from financial adversities due to the outbreak. The closure of residential facilities and the cancellation of face-to-face lectures resulted in the vast majority of the students moving back to their family home. Their daily routines were largely replaced by individual home activities, and social interactions shifted almost totally to digital platforms. They also reported high levels of anxiety and worries concerning a wide range of the possible detrimental outcomes of COVID-19, which were in close association with their knowledge, attitudes, and practices towards the disease, as well as their adherence to the policy measures and their satisfaction with the policies of the government. Conclusion These results may help policymakers in better understanding the psychosocial impacts of COVID-19 on the life of university students, and to develop more comprehensive strategies to address their multifaceted struggles, as well as to improve their compliance with the health measures in the future.
ALPHA PSYCHIATRY, 2021
Objective: This study aimed to draw a general picture of the impact of the coronavirus disease 20... more Objective: This study aimed to draw a general picture of the impact of the coronavirus disease 2019 (COVID-19) pandemic on the life of higher-education students in İstanbul, with specific emphasis on the relationship between students' social support systems, healthrisk behaviors, and mental/academic well-being. Methods: A total of 2583 higher-education students from different fields of study participated in an online survey gathering information from several domains, including available social networks, support-seeking attitudes, substance use patterns, physical activity levels, academic stress, academic satisfaction, and psychological well-being during the pandemic. Results: Our findings pointed to major changes in students' life circumstances and daily routines during COVID-19, including a significant decrease in contact with friends, overall substance use, and physical activity as well as high levels of depression, academic stress, and academic dissatisfaction. Depressive symptoms were significantly predicted by the loneliness score (OR = 2.08, 95% CI = 1.88-2.29), female gender (OR = 1.65, 95% CI = 1.21-2.24), frequency of binge drinking (OR = 1.4, 95% CI = 1.06-1.86), and level of academic stress (OR = 1.15, 95% CI = 1.1-1.19), whereas the number of people to easily borrow money from was found to be a protective factor against depression (OR = 0.95, 95% CI = 0.92-0.99). Conclusion: Our results highlight the need for higher-education institutions to take the appropriate social and mental health interventions, tailored to fit the specific requirements of the COVID-19-related measures.
Marmara Medical Journal, 2022
How to cite this article: Bulut NS, Yorguner N. Comparison of the intensity of peripheral inflamm... more How to cite this article: Bulut NS, Yorguner N. Comparison of the intensity of peripheral inflammation between major depressive disorder and bipolar depression by means of neutrophil-lymphocyte and platelet-lymphocyte ratios: The possible role of clinical severity and psychotic features.
Turk psikiyatri dergisi = Turkish journal of psychiatry, 2021
Functional (psychogenic) movement disorders (FMD) constitute a cluster of heterogeneous diagnoses... more Functional (psychogenic) movement disorders (FMD) constitute a cluster of heterogeneous diagnoses involving motor symptoms that cannot be explained by organic pathology and are often associated with underlying psychological problems. In psychiatry, patients with FMD are often placed within the scope of somatoform disorders and conversion disorders. Functional Parkinsonism (FP) is a rare form of FMD seen in 1.5% of all patients presenting with symptoms of parkinsonism. Although almost all symptoms of parkinsonism can be present in FP, clinical features such as sudden onset and a nonprogressive course, inconsistent response to pharmacotherapy, and atypical findings in neurological examination are considered as important clues of psychogenic aetiology. Limited data in the literature on FP indicate that the average age of onset is between 37-53 years of age, whereas the average onset age of Idiopathic Parkinson's Disease (IPD) is around 60; and Juvenile Parkinsonism, a rare conditio...
The severity of inflammation in major neuropsychiatric disorders: comparison of neutrophil–lymphocyte and platelet–lymphocyte ratios between schizophrenia, bipolar mania, bipolar depression, major depressive disorder, and obsessive compulsive disorder
Nordic Journal of Psychiatry, 2021
Abstract Background As non-specific markers of immune dysregulation, neutrophil–lymphocyte and pl... more Abstract Background As non-specific markers of immune dysregulation, neutrophil–lymphocyte and platelet–lymphocyte ratios (NLR and PLR) have been consistently shown to be increased in major neuropsychiatric disorders. Although this increase seems to be trans-diagnostic, the extent to which its magnitude differs between disorders remains largely unclear. Aim The aim of this study was to directly compare the severity of inflammation (as reflected by NLR and PLR) between schizophrenia (Sch), bipolar mania (BD-M), bipolar depression (BD-D), major depressive disorder (MDD) and obsessive compulsive disorder (OCD). Methods NLR and PLR were obtained for a total of 417 subjects (91 Sch, 70 BD-D, 37 BD-M, 93 MDD, 37 OCD, and 95 controls) and analyzed for group differences. Results Sch, BD-M, BD-D and MDD presented with significantly higher NLR compared with both OCD and HC. NLR in BD-M was significantly higher than all the remaining groups, whereas Sch, BD-D and MDD presented with comparably elevated NLR. Moreover, BD-M, Sch and MDD had significantly higher PLR compared with HC. Conclusion These results suggest that the underlying inflammation may be most severe in BD-M, followed by Sch, BD-D and MDD. On the other hand, inflammation may be of negligible intensity in OCD, or at least undetectable by means of NLR or PLR.
Acute onset psychosis with complex neurobehavioural symptomatology following the intramuscular injection of hyoscine butylbromide: a case report with an overview of the literature
European Journal of Hospital Pharmacy, 2020
Different compounds of hyoscine (scopolamine) are widely used for the treatment of a variety of c... more Different compounds of hyoscine (scopolamine) are widely used for the treatment of a variety of conditions, ranging from motion sickness to colic spasms and smoking cessation. In some rare conditions, the administration of scopolamine may lead to severe idiosyncratic reactions, including central anticholinergic intoxication syndrome. Here, we present a young female patient who progressively developed a series of complex neuropsychiatric symptoms including ataxia, slurred and rambling speech, stereotypic movements, vivid visual and auditory hallucinations, and self-mutilative behaviours in the days following the injection of hyoscine butylbromide in the emergency room to treat her menstrual cramps. Referred to psychiatry, detailed screening of her medical records and collateral information from the family revealed that the neurobehavioural manifestations were indeed preceded by severe peripheral anticholinergic toxicity, which were mostly overlooked during the initial evaluations. Started on olanzapine treatment, the patient’s symptoms gradually subsided over time, though it took several weeks to achieve full clinical recovery.
Balkan Medical Journal, 2020
Content of this journal is licensed under a Creative Commons Attribution-NonCommercial-NoDerivati... more Content of this journal is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. Background: Approximately half of the children with attention-deficit hyperactivity disorder continue to meet diagnostic criteria in adulthood. The prevalence of adult attention-deficit hyperactivity disorder is reported between 2.5% and 4.4% and is associated with significant impairment in quality of life and increased psychiatric comorbidity. Attention-deficit hyperactivity disorder in adults remains mostly undiagnosed and/or untreated despite the availability of effective treatments. The majority of people who do not receive necessary treatment are in the nonclinical or nonpsychiatric clinical population. Screening is an important step for diagnosing adults with attention-deficit hyperactivity disorder. Yet, there are no valid and reliable screening questionnaires calibrated for the Diagnostic and Statistical Manual for Mental Disorders-5 in Turkish. Aims: We aimed to test the reliability and the validity of the Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 screening questionnaire designed according to DSM-5 in the Turkish population. Study Design: Methodological and cross-sectional study. Methods: The translation was carried out according to the World Health Organization Composite International Diagnostic Interview translation guide using a linguistic adaptation approach. We used a convenience sampling method to recruit an individual with adult attention-deficit hyperactivity disorder (n = 68) and a control group (n = 68). The participants completed a sociodemographic form, 6-items Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5, and the previous version 18-items Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1 for the concurrent validity analysis. For the diagnostic validity, clinical diagnosis made by psychiatrists according to the Diagnostic and Statistical Manual for Mental Disorders-5 criteria was used. Internal consistency and item-total correlation coefficients, exploratory factor analyses, correlation with Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1, and receiver operating characteristic curve analysis were conducted. Results: The internal consistency measured by Cronbach alpha was 0.869. Item-total correlation coefficients were calculated to be between 0.602 and 0.717, and the correlations were statistically significant (P < 0.0001). The Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 showed to have a unidimensional factor structure explaining 60.54% of the variance. The correlation between Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 and Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1 total score was calculated as 0.992 (P < 0.0001), and that between Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 and Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-v1.1 attention-deficit subdimension was 0.868 (P < 0.0001). In the receiver operating characteristic analysis of Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5, the area under the curve was found to be 0.916. The cutoff score was calculated as 9 of 10 with a sensitivity of 85.2% and specificity of 89.7%. Conclusion: Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-5 is a valid and reliable self-report measure to assess and screen attention-deficit hyperactivity disorder in the Turkish population. It may be useful for both clinical and population studies.
Psychiatry and Clinical Psychopharmacology, 2018
OBJECTIVE: Children and adolescents facing difficult life circumstances due to social, economic a... more OBJECTIVE: Children and adolescents facing difficult life circumstances due to social, economic and cultural adversity, form a disadvantaged group in terms of social functioning and healthy psycho-social development. The goal of this study was to evaluate the psychological resilience of high school students in Muş Citywhich was ranked last in the general life index among 81 provinces according to 2015 data from the Turkish Statistical Instituteand to examine different dimensions of psychological resilience in relation to a variety of variables including adverse life events and demographic characteristics. METHOD: The study sample consisted of 1025 students from the 10th and 11th grades of five different high schools operating in the city centre of Muş. Participants were asked to fill in a socio-demographic questionnaire, the List of Adverse Life Events and the 59-item Resilience and Youth Development Module (RYDM). A series of correlational and descriptive analyses were then performed. RESULTS: Correlational analyses revealed that among the demographic factors, low economic status, a criminal record and poor academic performance were associated with poor psychological resilience, while among adverse life events, the deterioration of parental economic status, frequent arguments between parents as well as a history of mental illness and alcohol/substance abuse in the family were also linked to low levels of psychological resilience. It was also determined that girls had higher scores on internal assets of RYDM (empathy, problem solving, self efficacy, communication and cooperation, goals, self awareness and educational aspirations), while exposure to a larger number of adverse life events negatively affected internal resilience assets. Finally, trauma exposure, just as the low RYDM scores, seems to be associated with frequent arguments between parents, alcohol/ substance abuse in the family, male gender and a criminal record. However, there was no significant relationship between psychological resilience and trauma alone. CONCLUSION: Interventions to improve psychological resilience, which is a dynamic process, need to be comprehensive and multi-dimensional. In this context, it is crucial to elucidate the factors associated with the psychological resilience of children and adolescents exposed to a specific risk factor, such as adverse living conditions. In order to improve our understanding of psychological resilience and youth development in Turkey and to determine specific needs for interventions, future studies on various risk groups in different pilot citiesas in the example of Muşare needed.
Psychiatry Research, 2018
For 30 years, bright light therapy (BLT) has been considered as an effective, well-tolerated trea... more For 30 years, bright light therapy (BLT) has been considered as an effective, well-tolerated treatment for seasonal affective disorder (SAD). Because of low response rates, new treatment strategies are needed for bipolar depression (BD), which resembles SAD in certain respects. Few placebo-controlled studies of BLT efficacy have been carried out for BD. Accordingly, this study evaluates the efficacy and safety of BLT as an add-on treatment for BD. Thirty-two BD outpatients were randomly assigned to BLT (10000 lux) or dim light (DL, <500 lux). During a two-week period, light was administered each morning for 30 min. The Hamilton Rating Scale for Depression and the Montgomery-Ǻsberg Depression Rating Scale assessed clinical outcome, and the UKU Side Effects Rating Scale evaluated side effects. No significant difference was observed in baseline
International Journal of Psychophysiology, 2018
Previous research has increased understanding of the neurobiological basis of emotional regulatio... more Previous research has increased understanding of the neurobiological basis of emotional regulation. However, less is known concerning the unconscious processing of affective information. Three experiments were performed to investigate the extent to which complex affective stimuli can be processed outside of consciousness and demonstrate possible mechanisms for regulation of resulting emotional responses. In Experiment 1, participants were either instructed to passively observe blocked-picture cues (neutral and negative) or to downregulate their emotions by distancing. Resulting emotional regulation activity was assessed with 0.1-Hz heart rate variability (HRV) indices. In Experiment 2, participants were presented with affective pictures that were rendered consciously invisible by means of continuous flash suppression (CFS). In Experiment 3, two equivalent sets of negative affective pictures were covertly presented and the effect of a cognitive task on emotional regulation was evaluated. Our findings revealed that 0.1-Hz HRV indices exhibited greater change over baseline in response to negative compared to neutral stimuli for both presentation conditions (consciously perceived or not). The implementation of distancing and the cognitive task were both associated with higher 0.1-Hz HRV change scores. These results indicate that even complex affective stimuli can be processed without awareness, resulting in a congruent emotional response that is physiologically detectable. Cognitive strategies can help more effectively regulate this response, implying that conscious perception of a triggering stimulus may not be essential for cognitive regulation.
Psychiatry and Clinical Psychopharmacology, 2018
Objective: It has been proposed that anything does not kill you make you stronger. Although it mi... more Objective: It has been proposed that anything does not kill you make you stronger. Although it might be true in adult cases, children whose psychological life begin in the parental mind and shaped by the experiences during the early period of life are not as strong as adult against adverse effects of stressful events. Internalization of objects and emerging of internally working models, concept of normality and abnormality that will be the main ground for the understanding of the world in later life are emerged during childhood. That is why anything does not kill a child will shape its mind that might have everlasting effects on child.
Psychiatry and Clinical Psychopharmacology, 2018
Grief mania that is evaluated as psychogenic mania in the literature is related to manic episode ... more Grief mania that is evaluated as psychogenic mania in the literature is related to manic episode that emerges after the loss of a loved one. There are not many cases that associate causality of beginning of mania and mourning in the literature. It is known that mania is induced by traumatic events but the cases that do not suit stages of development of grief process are evaluated as pathological grief. In this case, the woman who experienced manic episode after her son's death is presented. This case is prepared because mania should be considered as possible grief reaction. Case presentation: A patient who is 40 years old, married, mother of 4 children is brought by relatives because of aggressiveness, tension, insomnia for 4 days, fast and talk a lot and nonsense laughing attacks. She was presented to hospital for stressful life events 2 years ago and started to be on medication (escitalopram 10 mg) because of depression and fibromiyaliji diagnosis. She used medication for 1.5 years and she did not use any medication for the last 6months. There is no history for mental disorder in her family. Psychological examination: her interest for the environment was increased, self-care ability got better, her temperament was cheerful, her sociability was respectful, amount of talking and tone of voice increased, mimic and gesture was appropriate for her temperament, sleeping decreased, thought flow increased and achieved goal of conversation late. Moreover, there were grandiose delusions and hypervigilance, affect was close to euphoria, her psychomotor behaviours increased and social functioning decreased. According to biochemical and radiological workup, there was no pathological situation. The client started to use Lithium 900 mg/day and Olanzapin 10 mg/day because of the bipolar disorder diagnosis. The patient's blood lithium level was 0.8mEq/L and lithium was used 1200 mg/day and then 10 days later the patient's blood lithium level was 0.72 mEq/L. According to clinical observations, the patient's manic symptoms remained. Furthermore, the patient started to cry occasionally after 1 month and her grandiosity disappeared. The patient was discharged from the hospital after 45 days. The patient met the criteria for manic episode in DSM 5. The patient did not take any medication for last 6 months. Thus, it is considered that this situation was not induced by medication. It puts the patient into risk group because she was treated for depression before but it is not considered as bipolar depression because there were psychiatric history in the family and depression that experienced 2 years ago was related to stressful life events. It is considered that this case experienced grief/funeral mania because there was contiguity between loss of her son and manic episode, the patient did not react this way to previous challenging life events and the patient was outside of the ordinary 5 stages of grief process.
Noro Psikiyatri Arsivi, 2016
Objective: Domestic violence (DV) is defined as all kinds of abusive behaviors between spouses or... more Objective: Domestic violence (DV) is defined as all kinds of abusive behaviors between spouses or relatives living in the same house. Domestic violence is most commonly directed towards women and children. This study aims to review the extent of domestic violence among women consulting to psychiatric outpatient clinic, and to identify its relation with sociodemographic risk factors and psychological symptoms. Method: Self-reported Domestic Violence Questionnaire and Symptom Checklist-90-R (SCL-90-R) information was collected from women who admitted to psychiatric outpatient clinic at Marmara University Research and Educational Hospital, and accepted to participate in the study. Results: 300 women participated in the study. Mean age of participants was 36.24±10.88, 75.7% of them were married, and mostly live within nuclear families. 70.1% of the participants reported verbal violence, and 49.0% reported physical violence. 65.3% of those who have experienced verbal violence have also experienced physical violence. 26.1% of them reported as not having experienced domestic violence before. The nature and extent of domestic violence, women's attitudes towards it, and its relation with experience of domestic violence during childhood have been explored. Participants' educational levels, current age and age of marriage, style of marriage, educational level and age of spouse were not found to be associated with experiencing of domestic violence. Both verbal and physical domestic violence were significantly associated with the economic status of women (p<0.05). The mean SCL-90-R score was 1.40±0.68 with the highest mean subgroup score under depressive symptoms category (1.80±0.79). Mean SCL-90-R score showed significant association with the experience of domestic violence (p≤0.001). Conclusion: Most of the women participated in the study have experienced domestic violence. Both verbal and physical violence increased with lower economic status. Psychiatric symptoms increased with the experience of domestic violence. Considering its high prevalence and detrimental psychological effects, domestic violence should be inquired by clinicians as part of the psychiatric interview.
Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry, 2017
Öz Yüksek morbidite ve mortalitesine karşın anoreksiya nervozanın psikolojik tedavilerine yönelik... more Öz Yüksek morbidite ve mortalitesine karşın anoreksiya nervozanın psikolojik tedavilerine yönelik araştırmalar sınırlı sayıdadır. Bu yazıda, anoreksiya nervozaya yönelik çeşitli psikososyal tedavi yöntemlerinin genel hatlarıyla tanıtılması ve bu yöntemlerin etkinliklerine dair randomize kontrollü çalışmaların güncel bir derlemesinin yapılması amaçlanmıştır. Derlenen araştırmalar, ergenler üzerinde yürütülen çalışmalar ve ergenlerle erişkinlerin birlikte olduğu çalışmalar olmak üzere iki ana başlık altında incelenmiş; diğer değişkenlerle ilgili hususlar ayrıca ele alınmıştır.