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Öğe Analysis of Social Class by LCA in Patients with Schizophrenia: Change in Psychopathology after 12 Month of Treatment(Kure Iletisim Grubu A S, 2009) Saylan, Mete; Ucok, Alp; Uguz, Suekrue; Treuer, Tamas; Sir, AytekinObjective: The social factors may contribute to the heterogeneous course of schizophrenia and relationship between these factors and the level of care received is complex. Social factors may influence access to treatment and outcome of the disease. Current diagnostic systems classify longitudinal course of schizophrenia based on symptom patterns. We aimed to identify latent social classes in Turkish patients with schizophrenia who participated to IC-SOHO observational study. Latent class analysis may allow a physician to understand various patient social groups (social casemix) in a very heterogeneous patient data flow seen in everyday practice. Method: 692 outpatients with schizophrenia (ICD-10 or DSM-IV), who were initiated or switched to antipsychotic treatment, were included in this 3-year, non-interventional, prospective, observational study. Information regarding social functioning items including housing (independent, dependent, supervised, or hospitalized), work status (employed paid/unpaid, unemployed able to work/unable to work, or retired), number of social activities in past 4 weeks, and relationship with spouse or partner, were collected by interviewing the patients and relatives. We performed a latent class analysis acording to patient's indicators of social functioning to identify social classes. We compared mean change of psychopathology among social classes for all patients and for patients treated with antipsychotic monotherapy for one year. Results: Data for baseline indicators used in the casemix analysis were available for 614 patients. We identified 5 classes of patients (inactives, 38.9%; in a relationship, 29.5%; no relationship unemployed dependents, 15.3%; no relationship employed dependents, 11.6%; no relationship retirees, 4.8%) that share similar characteristics, (likelihood ratio chi-square=107.1, df=347) with 4 aspects of social functioning items. There was no statistical difference among social classes in the improvement of positive, negative, and overall symptom severity at the end of one year naturalistic follow-up. CGI-S score decreases from baseline for positive symptoms were significantly higher with atypical antipsychotics when compared to typicals. Conclusion: The categorical modeling of social functioning may be a simple and valid tool for the further exploration ofthe classes in schizophrenia patients. Testing for long-term efficacy of different treatments in the putative groups may provide valuable insight for functional outcomes of patients with schizophrenia.Öğe Bipolar disorder treatment(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2013) Sir, Aytekin; Bulut, Mahmut[Abstract Not Available]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 High social phobia frequency and related disability in patients with acne vulgaris(John Libbey Eurotext Ltd, 2011) Bez, Yasin; Yesilova, Yavuz; Kaya, Mehmet Cemal; Sir, AytekinAcne is an easily recognizable abnormality which may cause some adverse psychosocial consequences. We aimed to determine the social phobia frequency, social anxiety level, and disease related disability in a group of acne vulgaris patients. One-hundred and forty acne vulgaris patients and 98 healthy control subjects were included in the study. Acne severity was determined by the Global Acne Grading System (GAGS). A psychiatrist interviewed each participant and the Liebowitz Social Anxiety Scale (LSAS) was administered to all participants, who also completed the Hospital Anxiety and Depression Scale (HADS) and Sheehan Disability Scale (SDS). Social phobia was diagnosed in 45.7% of acne vulgaris patients and in 18.4% of control subjects. Acne vulgaris patients demonstrated higher performance avoidance and total avoidance scores in LSAS than controls. Acne vulgaris patients without social phobia had higher scores in HADS and LSAS than the acne vulgaris patients with social phobia. They were more disabled in their occupational, social, and familial lives. Social phobia diagnosis predicted disability at work, whereas education level predicted the disability in family life of acne vulgaris patients. Social phobia seems to be a common psychiatric comorbidity which may give rise to some additional disability among acne vulgaris patients.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 Longer-term treatment of patients with bipolar disorder: a 9-month observational study in Central and Eastern Europe, the Middle East and Africa(Taylor & Francis Ltd, 2009) Okasha, Tarek A.; Kucukalic, Abdulah; Nasr, Aly Akram A.; Zelman, Marek; Karamustafalioglu, Oguz; Sir, Aytekin; Harrison, GavanObjective: To compare the longer-term outcomes of pharmacological treatment of patients with a diagnosis of bipolar affective disorder currently suffering a manic or hypomanic episode prescribed olanzapine or non-olanzapine medication in naturalistic, clinical practice settings in Bosnia-Herzegovina, Slovakia, Slovenia, Turkey, Saudi Arabia and Egypt. Research design and methods: Prospective, observational, non-interventional study conducted over 9 months. Inpatients or outpatients who initiated or changed oral bipolar mania medication were grouped into (1) those prescribed olanzapine at baseline (n = 569) and (2) those not prescribed olanzapine (n = 325). Main outcome measure(s): The change from baseline in the Clinical Global Impression Severity scale for bipolar disorder (CGI-BP-S), the rates of symptomatic response and remission (based on CGI-BP-S) and the frequency and nature of treatment-emergent adverse events. Analyses included (1) linear or logistic regression, with adjustment for confounders, based on the last observation carried forward and (2) weighted repeated measures models that adjusted for treatment switching and patient drop-out. Results: When results were adjusted for treatment switching and patient drop-out, patients prescribed olanzapine had significantly better CGI-BP-S scores (mean difference = -0.24; 95% confidence interval [CI] -0.33, -0.16; p<0.001) and significantly greater odds of treatment response (odds ratio [OR] = 1.86; 95% CI 1.31, 2.65; p<0.001) and symptom remission (OR 1.65; 95% CI 1.18-2.32; p = 0.003) than those not prescribed olanzapine. The frequency of most adverse events decreased in both groups. Patients prescribed olanzapine had significantly greater weight gain from baseline (mean increase 2.66 kg; 95% CI 2.35, 2.98) compared with those not prescribed olanzapine (mean increase = 1.85 kg; 95% CI 1.51, 2.19; p<0.001). Conclusions: Inclusion of olanzapine is of benefit for pharmacological treatment of patients with bipolar disorder. However, the favourable outcomes observed cannot be directly attributed to olanzapine alone because of the high prevalence of polypharmacy in the patient population.Öğe Suicide Attempt with Paliperidone Overdose: A Case Report(Kure Iletisim Grubu A S, 2010) Bez, Yasin; Donmezdil, Suleyman; Sir, AytekinSuicide is a common problem seen in patients with schizophrenia. Taking overdoses of drugs is a well-known way for committing suicide. We report a case with schizophrenia, who attempted suicide with 243 mg. of paliperidone, a recently marketed atypical antipsychotic, and admitted to our emergency service with restlessness, agitation, mild confusion, and disorganized behavior. Gastric lavage, hydration, and 72 hours monitorization of the patient in intensive care unit ended without any sequelae. Our case, in addition to the limited available data, suggests paliperidone is a relatively safe drug in its overdoses.
