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Öğe Acute Unilateral Myopia Induced by Add-On Aripiprazole: A Case Report(Kure Iletisim Grubu A S, 2016) Gunes, Mehmet; Demir, Suleyman; Bulut, Mahmut; Kaya, Mehmet Cemal; Atli, Abdullah; Ibiloglu, Aslihan Okan; Yuksel, HarunThe partial agonist aripiprazole is a novel atypical antipsychotic with a relatively safer side effect profile. Acute unilateral myopia is a very rare condition that is commonly associated with drug use. Here, we present a woman diagnosed with obsessive-compulsive disorder (OCD) and major depressive disorder (MDD) who have been treated for two years in our clinic. She was on fluoxetine (Prozac) 80 mg/day when adding aripiprazole (Abilify) 10 mg/day as an augmentation agent has triggered unilateral myopia. After cessation of aripirazole her myopia has disappeared. Psychiatrists should keep in mind that unilateral myopia as a side effect may develop after combining aripiprazole with fluoxetine in patients with OCD and MDD.Öğe A Case of Skin Picking Disorder of a Patient with a History of Childhood Abuse(Aves, 2016) Okan Ibiloglu, Aslihan; Atli, Abdullah; Kaya, Mehmet Cemal; Demir, Suleyman; Bulut, Mahmut; Sir, AytekinSkin picking (excoriation) disorder is the recurrent excoriation of one's own skin, resulting in noticeable skin damage. People pick their skin for different reasons. For the majority of patients, first skin picking is associated with a history of childhood abuse and personal problems. Subjects who moderately to severely cause injurious self-harm are more likely to have a history of exposure to domestic violence and childhood abuse than those who do not self-harm. At the same time, these conditions could be related to the etiology for majority of other psychiatric disorders. We report herein, a case of a patient with skin picking disorder who had a history of childhood physical and emotional abuse with borderline personality disorder.Öğe A case who had deliberate self-harm by inserting needles to her body for 12 years(Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2016) Okan Ibiloglu, Aslihan; Atli, Abdullah; Demir, Suleyman; Sir, AytekinDeliberate self-harm or self-injurious behaviors (SIB) defined as 'the intentional, direct injuring of body tissue without suicidal intent' in addition to this topic has generated mounting interest among mental health professionals, over the past years. Psychiatric disordered patients have the tendency to self-harm repeatedly. We report here, a case that was referred for SIB with deliberately inserted needles in her body, over the last 12 years.Öğe Decreased Prolidase Activity in Patients with Posttraumatic Stress Disorder(Korean Neuropsychiatric Assoc, 2016) Demir, Suleyman; Bulut, Mahmut; Atli, Abdullah; Kaplan, Ibrahim; Kaya, Mehmet Cemal; Bez, Yasin; Ozdemir, Pinar GuzelObjective Many neurochemical systems have been implicated in the development of Posttraumatic Stress Disorder (PTSD). The prolidase enzyme is a cytosolic exopeptidase that detaches proline or hydroxyproline from the carboxyl terminal position of dipeptides. Prolidase has important biological effects, and to date, its role in the etiology of PTSD has not been studied. In the present study, we aimed to evaluate prolidase activity in patients with PTSD. Methods The study group consisted of patients who were diagnosed with PTSD after the earthquake that occurred in the province of Van in Turkey in 2011 (n=25); the first control group consisted of patients who experienced the earthquake but did not show PTSD symptoms (n=26) and the second control group consisted of patients who have never been exposed to a traumatic event (n=25). Prolidase activities in the patients and the control groups were determined by the ELISA method using commercial kits. Results Prolidase activity in the patient group was significantly lower when compared to the control groups. Prolidase activity was also significantly lower in the traumatized healthy subjects compared to the other healthy group (p<0.01). Conclusion The findings of the present study suggest that the decrease in prolidase activity may have neuroprotective effects in patients with PTSD.Öğe Diagnostic performance of increased prolidase activity in schizophrenia(Elsevier Ireland Ltd, 2016) Gunes, Mehmet; Bulut, Mahmut; Demir, Suleyman; Ibiloglu, Aslihan Okan; Kaya, Mehmet Cemal; Atli, Abdullah; Kaplan, IbrahimWe investigated whether prolidase activity has a diagnostic test value in schizophrenia and assessed the relation between prolidase activity and sociodemographic-clinical characteristics of patients with schizophrenia. Fifty patients with schizophrenia (diagnosed as schizophrenia according to DSM-V criteria) and 50 healthy volunteers were included in this study. Case and control groups had a similar distribution in age, sex, body mass index (BMI), and smoking status. Serum prolidase activity was measured in both groups and was determined to be significantly higher in the patient group (509.706 +/- 41.918) compared to the control group (335.4 +/- 13.6; t = 6.231; p = 0.0001). A cut-off point of 392.65 U/L prolidase was determined for diagnostic measures from the plotted ROC curve. The area under the ROC curve was 1.000, which was significant (p < 0.0001). Higher values were assigned as the disease state. Both positive predictive value (PPV) and negative predictive value (NPV) were 100% at the cut-off point of 392.650 U/L. The prolidase levels of the control group were all below the cut-off point. There were no statistically significant differences between the two groups with regard to age, gender, or BMI (p > 0.05), and no correlation was found between mean prolidase activity and age of onset of the disease, family history, disease duration, number of hospitalizations, subtypes of schizophrenia, PANSS scores or sub scores, CGI-S scores, S-A scale scores, and the antipsychotic treatment (p > 0.05). The results of this study indicate that serum prolidase activity may be a useful diagnostic test for schizophrenia; however, further studies are needed to verify this. (C) 2015 Elsevier Ireland Ltd. All rights reserved.Öğe ELEVATED NEUTROPHIL/LYMPHOCYTE RATIO IN PATIENTS WITH SCHIZOPHRENIA(Medicinska Naklada, 2014) Semiz, Murat; Yildirim, Osman; Canan, Fatih; Demir, Suleyman; Hasbek, Ekrem; Tuman, Taha Can; Kayka, NefiseBackground: Inflammatory mechanisms are reported to play important roles in the pathophysiology of schizophrenia. The neutrophil-lymphocyte ratio (NLR) is a simple and easily accessible indicator of the systemic inflammatory response. Our goal was to investigate whether NLR was higher in patients with schizophrenia than in healthy comparison subjects similar in age, sex, and body mass index. Subjects and methods: In this multicenter cross-sectional study, we analyzed 156 non-obese patients with schizophrenia and 89 healthy control subjects for complete blood count. The Brief Psychiatric Rating Scale was used to determine the severity of clinical pathology. Results: The mean +/- SD NLR of patients with schizophrenia was significantly higher than that of healthy controls (2.6 +/- 1.1 vs. 1.9 +/- 0.6, respectively, p<0.001). NLR did not significantly correlate with severity and duration of schizophrenia (r=0.065. p>0.05). Conclusions: Our findings suggest that NLR levels are increased in physically healthy, non-obese, patients with schizophrenia when compared with physically and mentally healthy individuals. To our knowledge, this is the first study that demonstrated the association between NLR and schizophrenia.Öğe Evaluation of Paraoxonase, Arylesterase and Malondialdehyde Levels in Schizophrenia Patients Taking Typical, Atypical and Combined Antipsychotic Treatment(Korean Coll Neuropsychopharmacology, 2016) Gunes, Mehmet; Camkurt, Mehmet Akif; Bulut, Mahmut; Demir, Suleyman; Ibiloglu, Aslihan Okan; Kaya, Mehmet Cemal; Atli, AbdullahObjective: Human serum paraoxonase (PON1) prevents lipids from peroxidation and functions as an antioxidant mechanism. Malonyldialdehyde (MDA) is the final product of lipid peroxidation and can be used as an indicator of oxidative stress. The aim of this study was to investigate PON1, MDA, and arylesterase (ARY) levels in schizophrenic patients who, are taking typical, atypical, or combined (typical and atypical) antipsychotic drug treatment, with respect to those of healthy controls, Methods: We evaluated 41 patients (11 taking typical antipsychotics, 19 taking atypical antipsychotics, 11 taking combined anti psychotics) and 43 healthy controls. Results: MDA levels were higher in schizophrenic patients taking typical antipsychotics compared with healthy controls (p=0.001). ARY levels were higher in patients taking atypical antipsychotics compared with healthy controls (p=0.005): PON1 activity was similar in all groups. Conclusion: Our results indicate that treatment with typical antipsychotic drugs could be related to increased MDA levels; and antipsychotic medication may increase PON1 levels in schizophrenic patients.Öğe Evaluation of Risk Factors for ADHD and Co-Morbid Psychiatric Disorders Among the Parents of Children With ADHD(Sage Publications Inc, 2019) Ibiloglu, Aslihan Okan; Atli, Abdullah; Bulut, Mahmut; Gunes, Mehmet; Demir, Suleyman; Kaya, Mehmet Cemal; Yuksel, TugbaObjective: The aim of this study is to investigate the presence of ADHD and other psychiatric disorders among parents with at least one child with ADHD relative to parents with children who do not have ADHD. Method: Eighty five parents of children with ADHD with 68 control parents who had healthy children without ADHD were interviewed for participation in present study. Each parent was evaluated for co-existing psychiatric disorders using the Structured Clinical Interview for the DSM IV Axis I Disorders (SCID I). Results: We found that ADHD and co-morbid psychiatric symptoms were increased in the parents of children with ADHD in comparison with the healthy control group. Conclusion: Psychiatric co-morbidity was more common among the parents of patients with inattentive and combined presentations. Adult ADHD is associated with psychiatric co-morbidities including anxiety disorders, mood disorders, and somatoform disorders as well as substantial role impairment.Öğe An Evaluation of the Psychometric Properties of Three Different Forms of Daly and Miller's Writing Apprehension Test through Rasch Analysis(Edam, 2017) Guler, Nese; Ilhan, Mustafa; Guneyli, Ahmet; Demir, SuleymanThis study evaluates the psychometric properties of three different forms of the Writing Apprehension Test (WAT; Daly & Miller, 1975) through Rasch analysis. For this purpose, the fit statistics and correlation coefficients, and the reliability, separation ratio, and chi-square values for the facets of item and person calculated for the 26-item, one-dimensional, 21-item, one-dimensional and 21-item, four-dimensional forms of the test were compared. The study was conducted with 720 secondary-school students in Nicosia, Northern Cyprus. Having excluded the incomplete or incorrectly completed measurement tools, data for 604 students remained in the data set. The data obtained from the research were analyzed through the Rasch model by making use of the FACETS package program. The results demonstrated that the 21-item, one-dimensional model was the most appropriate model for the WAT. Aside from this, more accurate estimations were found able to be made for students' writing apprehension by adding items with differing levels of difficulty (higher or lower than existing items) into the test.Öğe Increased High Mobility Group Box1 (HMGB1) level in major depressive disorder(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2015) Demir, Suleyman; Bulut, Mahmut; Kaya, Mehmet Cemal; Sevim, Bunyamin; Demirpence, Ozlem; Ibiloglu, Aslihan Okan; Gunes, MehmetObjective: It was reported that High Mobility Group Box 1 (HMGB1), also known as the nuclear transcription factor, is a late mediator of inflammation. It was thought that HMGB1 has a prominent role in the activation of Tumor Necrosis Factor-a (TNF-alpha), Interleukin (IL)-1 beta and IL-8 which are proinflammatory mediators during inflammation. HMGB1 plays a role in progress, diagnosis and prognosis of immune system illnesses. Besides suppressing the immune system, Major Depressive Disorder (MDD) was indicated to cause changes in inflammatory processes. Biological determinants affecting the diagnosis, therapy, and prognosis of depression are quite limited. Therefore, new etiological models are needed to explain the pathophysiology of depression. There is no study in the literature investigating level of HMGB1 in MDD of the humans. This study aims to examine the role of inflammation in the etiology of depression based on the HMGB1 in patients with MDD. Methods: A total of 30 patients diagnosed with MDD were included in the study. The control group consisted of 30 healthy subjects without any psychiatric disorders. A socio-demographic information form, Hamilton Depression Rating Scale (HDRS) and Clinical Global Impression Scale (CGIS) were administered, and blood was taken for measurement of HMGB1 levels. Results: Significantly higher HMGB1 values were identified with the patient group when compared to the control group (p<0.05). Conclusion: Our study is the first in which HMGB1 level was investigated in MDD ot the humans. The findings of the study reveal that HMGB1 tends to be higher in patients with MDD, and a high HMGB1 value supports the view that inflammation might have a critical role in the etiology of MDD.Öğe The investigation of factors related to suicide attempts in Southeastern Turkey(Dove Medical Press Ltd, 2016) Ibiloglu, Aslihan Okan; Atli, Abdullah; Demir, Suleyman; Gunes, Mehmet; Kaya, Mehmet Cemal; Bulut, Mahmut; Sir, AytekinBackground: Suicide is an important health problem in Turkey as it is in all regions of the world. Suicidal behavior has multiple causes, which are broadly divided into those related to proximal stressors and those due to predisposition. Suicide statistics may be associated with mental health disorders, which are among the foremost predictors of suicide attempts. More than 90% of patients who commit suicide have a diagnosable psychiatric disorder, usually a major depressive disorder. Other major risk factors for suicide attempts are history of suicide attempts in the family, stressful life events, sleep disturbances, poor income, unemployment, severity of symptoms of depression, and anxiety. Sleep is a complex phenomenon. Sleep disturbances can therefore be contributed to the emergence of suicidal behavior allowing for the possibility of predicting future suicides. Methods: We evaluated 106 patients who were admitted after suicide attempts to the Department of Psychiatry at Dicle University Faculty of Medicine. The recruited subjects were assessed by Structured Clinical Interview for DSM-IV Axis I disorders, and the intensity of symptoms was evaluated using the Beck Anxiety Inventory, Hamilton Depression Rating Scale, and Pittsburgh Sleep Quality Index. The mean values of the subjects attempting multiple and single suicides were compared using appropriate inferential statistical tests. Results: Most suicide attempts are believed to be preventable. Our results revealed that a great variety of risk factors are associated with an increased risk for multiple suicide attempts. Most of these attempts appeared to be spontaneous and impulsive rather than planned. In particular, this study highlights the importance of previous suicide attempts, history of suicide in the family, history of stressful life events in the previous 6 months, poor income, unemployment, sleep disturbances, severe hopelessness with depression, and coexisting symptoms of anxiety as risk factors. Conclusion: The first step in prevention of suicides is doubtlessly strong and reliable communication, due to the fact that the majority of subjects who commit suicide have had contact with a health professional during the month before the suicide.Öğe Neutrophil-lymphocyte ratio in patients with major depressive disorder undergoing no pharmacological therapy(Dove Medical Press Ltd, 2015) Demir, Suleyman; Atli, Abdullah; Bulut, Mahmut; Ibiloglu, Aslihan Okan; Gunes, Mehmet; Kaya, Mehmet Cemal; Demirpence, OzlemStudies attempting to clarify the relationship between major depressive disorder (MDD) and the immune system have been increasing in recent years. It was reported that increased production of the main proinflammatory cytokines, such as interleukin-1, interleukin-6, and tumor necrosis factor-alpha, and that of acute phase reactants may play a role in the etiopathogenesis of depression. Stress and depression were reported to increase leukocyte and neutrophil counts and to decrease lymphocyte count. Biological determinants affecting the diagnosis, therapy, and prognosis of depression are quite limited. Therefore, new etiological models are needed to explain the pathophysiology of depression. In recent years, neutrophil-lymphocyte ratio (NLR) was determined to be a good indicator of inflammatory status. There is no study in the literature investigating NLR in MDD. This study aims to examine the role of inflammation in the etiology of depression based on the NLR in MDD patients who are undergoing no pharmacological therapy. A total of 41 patients diagnosed with MDD, who received no antidepressant therapy within the past 1 month, were included in the study, which took place between January and March 2015. The control group consisted of 47 healthy subjects with no psychiatric disorders. A sociodemographic information form and a Beck Depression Scale were administered, and the blood was taken for biochemical analysis. Significant differences were identified in the NLR, neutrophil count, lymphocyte percentage, and leukocyte values of the patient group when compared with the control group (P < 0.05). Our study is the first in which NLR was investigated in MDD. The findings of the study reveal that NLR tends to be higher in patients with MDD, and a high NLR value supports the view that inflammation is a critical factor in the etiology of MDD.Öğe Oxidative metabolism may be associated with negative symptoms in schizophrenia(Taylor & Francis Ltd, 2017) Gunes, Mehmet; Altindag, Abdurrahman; Bulut, Mahmut; Demir, Suleyman; Ibiloglu, Aslihan Okan; Kaya, Mehmet Cemal; Atli, AbdullahObjective: In the present study, we aimed to examine the relationship between the oxidative metabolism with disease severity, sociodemographic, and clinical characteristics in the patients with schizophrenia. Methods: Seventy-one patients with schizophrenia and 76 healthy volunteers were included in the study. Plasma total antioxidant level (TAL) and total oxidant level (TOL) were analyzed, and oxidative stress index (OSI) was calculated. Results: There was a statistically significant increase in TOL and OSI and decrease in TAL in the patients with schizophrenia compared to the controls (p <.05). There were positive, mild, statistically significant correlations between TOL, OSI, and Positive and Negative Syndrome Scale-Total scores (p =.01, p =.01, respectively), Positive and Negative Syndrome Scale-Negative scores (p =.002, p =.001, respectively), Positive and Negative Syndrome Scale Global Psychopathology scores (p =.03, p =.03, respectively), and Clinical Global Impression-Severity Scale scores (p =.008, p =.009 respectively). OSI levels were significantly lower in the patients who were on treatment with atypical antipsychotics (AAP) compared to the patients who were on typical antipsychotics (TAP) and combined antipsychotic (CAP) agents (p =.032). Conclusions: Oxidative stress was higher in schizophrenia patients. The increased severity of negative symptoms was in line with the disruption in oxidative balance. Oxidative stress is quite lower in AAP users compared to the TAP and CAP users. One of the mechanisms underlying the fact that AAPs are more effective on negative symptoms than typical agents may be the positive effect on the oxidative stress.
