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Öğe Adult ADHD prevalence in Sivas province and comorbid axis-I, axis-II diagnoses(CUMHURIYET UNIV TIP FAK PSIKIYATRI ANABILIM DALI, 2011) Yapicioglu, Bekir; Kavakci, Onder; Guler, Aysegul Selcen; Semiz, Murat; Dogan, OrhanObjective: The purpose of this study was to determine the adult ADHD prevalence in Sivas province, to identify sociodemographic characteristics and comorbid axis-I and axis-II diagnoses in adults with ADHD. Methods: ASRS was administered to 901 subjects between 18-44 years of age and Childhood and Adulthood Attention Deficit and Hyperactivity module of MINI Plus 5.0.0 was administered to 28 out of 34 subjects who had ASRS scores above cutoff point and who accepted clinical interview. SCID-I and SCID-II were used to evaluate comorbid axis-I and axis-II diagnoses in subjects with ADHD. Findings: Screening with ASRS revealed a prevalence rate of 3.8% which dropped to 2.7% with the structured clinical interview. Adult ADHD was found to be higher (83.3%) in women in this sample which was statistically significant. Subjects with ADHD had lower employment status, more frequent job changes, medium level of income, more suicide attempts, more cigarette consumption, more psychiatric diagnoses on behalf of themselves and in their parents and more reported psychiatric need when compared to subjects without ADHD. 83% of the subjects with ADHD (n=20) had comorbid axis I diagnoses. Most common comorbid diagnoses were obsessive compulsive disorder, major depression and dysthymic disorder, each of which were 20.8%. 33.3% of the patients didn't have any axis II diagnoses. Most common axis II diagnoses were obsessive compulsive personality disorder (25%)and passive aggressive personality disorder (25%). Discussion: In conclusion, the main clinical implication of this study is that ADHD is a persistent diagnosis in adulthood. Given the high prevalence of adult ADHD and its high comorbidity with other psychiatric disorders, ADHD should be considered as a possible comorbid diagnosis for many patients in adult psychiatry clinics, especially for those who show continued impairment despite appropriate treatment or the presenting disorder. (Anatolian Journal of Psychiatry 2011; 12:177-184)Öğe Dermatoglyphic characteristics in panic disorder(DRUNPP-SARAJEVO, 2010) Sabanciogullari, Vedat; Ersan, E. Erdal; Dogan, Orhan; Dogan, Selma; Sabanciogullari, SelmaObjectives: Panic disorder is one of the most common anxiety disorders. There are various etiological factors in panic disorder. Dermatoglyphics are special patterns formed by epidermal ridges in fingertips, palms and soles. They form during the intrauterine period and remain unchanged throughout life. Genetic diseases can change the form and structure of dermatoglyphics. The aim of this study was to evaluate fingertip and palmar dermatoglyphic samples of panic disorder patients and to compare these with the control group. Materials and methods: Dermatoglyphic data was collected from 50 patients diagnosed with panic disorder according to DSM-IV diagnostic criteria and from a control group consisting of 50 healthy people. Data was collected using a digital scanner and was transferred to computer medium. Using the Image J program, atd, dat, adt angles, a-b ridge counts, sample types of all fingers and ridge counts were calculated. Data was analyzed using t-test, Mann Whitney U and chi-square tests. Findings: It was found that the a-b ridge count in both hands and the ridge count in the thumbs of panic disorder patients were significantly higher those of the control group. It was found that, in the right hands of panic disorder patients, there was a significant increase in ridge counts in the ring finger, total ridge count and adt angle when compared to the control group. However, there was no significant difference between the groups in terms of dermal ridges, and the most common characteristic in both groups was ulnar loops. Results: Analyzing dermatoglyphics is non-invasive, straightforward, quick and economical. The use of dermatoglyphics can facilitate identification and early diagnosis of those at risk of panic disorder, allowing preventive measures to be taken.Öğe Diffusion-Weighted Imaging Study in Euthymic Patients with Bipolar I Disorder(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2012) Erden, Aslihan C.; Kugu, Nesim; Oztoprak, Ibrahim; Dogan, Orhan; Akyuz, GamzeObjective: To examine the possible presence of white matter abnormalities and apparent diffusion coefficient (ADC) changes by using diffusion-weighted magnetic resonance (MR) imaging, in patients with euthymic bipolar I disorder. Method: Thirty patients (12 women, 18 men) were included in this study. The patients, whose total Young Mania Rating Scale points were 5 or less at least for four weeks, and whose total Hamilton Depression Rating Scale points were 7 or less were considered as euthymic. The control group was consisted of age and gender matched 30 healthy individuals. ADC values were obtained symmetrically from the frontal, temporal, and occipital lobes and the genu of the corpus callosum, where white matter tissue was the largest. Results: The mean ADC value of the bipolar group was determined as 856.53 +/- 88.31x10(-3)mm/s, and that of the control group was 778.89 +/- 89.67x10(-3)mm/s. The mean ADC values on the right frontal area was found to be lower in bipolar patients as compared to that of the control group, but the difference was statistically insignificant. However, it was found significantly lower on the left hemisphere (p<0.05). The increases of the mean ADC values obtained from both right and left temporal and occipital lobes of bipolar group were found to be statistically significant as compared to those of the control group (p<0.05). Conclusions: According to the results of this study, the increased ADC values in euthymic bipolar patients may probably be related to the disintegration of white matter. Besides, decreased ADC values obtained from the frontal areas suggest that the disintegration might be reversible.Öğe EMDR (Eye Movement Desensitization and Reprocessing): A Different Option in Psychotherapy(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2010) Kavakci, Onder; Dogan, Orhan; Kugu, NesimIn recent years, there has been an interest in using the EMDR (Eye Movement Desensitization and Reprocessing) therapy. One of the reasons for this interest may be its effectiveness shown by numerous studies, especially, conducted with individuals who suffer from Post Traumatic Stress Disorder (PTSD). The EMDR is known to be an innovative approach that accelerates information processing and facilitates the integration of fragmented traumatic memories. This process is stated to allow better integration of the information that a person has to handle in the future. Recent practice guidelines and meta-analyses have designated the EMDR as a first-line treatment for trauma. Although the prevalences of trauma and trauma related disorders are high in Turkey, there has been a limited number of published studies highlighting treatment options. The EMDR's mechanism of action has not yet been fully explained. Shapiro has proposed an adaptive information processing model. Later, based on laboratory and neuroimaging methods, a number of neurobiological models have been suggested. The present study explained the EMDR and its eight-phases. A case example with session records was provided to show the application and operation of the technique. After that, leading neurobiological models which attempt to explain the mechanisms of action of the EMDR were summarized. Finally, few studies conducted in Turkey using the EMDR were reviewed. Given the effectiveness of the EMDR regarding trauma and related disorders, the utilization of the technique by a broad number of mental health professionals may not only increase the professionals' competency on psychiatric disorders, but also may provide patients suffering from these disorders a chance to recover in a relatively short period of time.Öğe Examination of free radical metabolism and antioxidant defence system elements in patients with obsessive-compulsive disorder(PERGAMON-ELSEVIER SCIENCE LTD, 2006) Ersan, Serpil; Bakir, Sevtap; Ersan, E. Erdal; Dogan, OrhanFree radicals and oxidative stress are involved in the pathogenesis of various diseases. Malondialdehyde (MDA) is a natural product of lipid peroxidation in all mammalian cells. Vitamins C and E are nonenzymatic antioxidant structures. Our study investigated the role of free radicals in the obsessive-compulsive disorder (OCD). The participants were 30 patients with OCD that were drug-free at least for a month and a control group of 30 healthy subjects, matched with respect to age and sex. In both groups, the levels of erythrocyte malondialdehyde and the plasma vitamin C and E concentrations were measured. The levels of malondialdehyde were significantly higher in the patient group than in the control group (p < .01). The levels of plasma vitamin E were significantly lower in the patient than in the control group (p < .02). Although our patient group had slightly lower concentrations of plasma vitamin C compared to our control group, the difference between these two groups was not statistically significant. There was a significant correlation between increasing malondialdehyde levels and decreasing vitamin E concentrations. This study shows the presence of a significant relationship of OCD and oxidative stress, and consequently, an involvement of free radicals and of the antioxidant defence. Biochemical studies may contribute to the understanding of OCD and its treatment. (c) 2006 Elsevier Inc. All rights reserved.Öğe Fahr's Disease: A Case Report(AVES, 2011) Dogan, Orhan; Meydan, Gungor; Semiz, Murat; Yildirim, Osman; Yontar, GozdeFahr's disease is a rare neuropsychiatric illness characterized by bilateral calcifications of the basal ganglia and white matter. Although its etiology is not yet fully understood, infectious, metabolic and genetic factors have been demonstrated in some cases. Movement disorders, together with dementia and psychiatric symptoms, may be observed as the clinical manifestations of Fahr's disease. In this case report, a 53-year-old male patient who had complaints of skepticism and nervousness was reported. His physical examination revealed signs of dementia. The serum ionized calcium, phosphorus and parathyroid hormone levels were within normal limits. A computed tomography scan of the brain demonstrated bilateral calcifications. (Archives of Neuropsychiatry 2011; 48: 82-4)Öğe Frontotemporal Dementia: a Case Presentation(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2010) Kugu, Nesim; Dogan, Orhan; Kavakci, Onder; Terlemez, IbrahimFrontotemporal dementia (FTD) is, next to Alzheimer disease, the most frequently encountered form of primary degenerative dementia among middle-aged subjects. It generally begins insidiously between the ages of 45 and 65 years, and is seen in both genders with equal frequency. It is characterized by changes in personality, behavior, and affect, in addition to loss of insight, perseverative and stereotypical behaviours, and changes in eating habits. These patients appear normal upon neurological examination and routine electroencephalography (EEG), but brain imaging reveals focal abnormalities in the frontotemporal lobes. There is significant deficiency in executive functions. This study describes a male patient with FTD that had began insidiously in his fifties, and in whom the changes in personality and impairment in behavior were the striking symptoms (loss of insight, hyperorality, and dietary changes; compulsive and stereotypical behaviours; blunted affect, decrease in the amount of speech and retardation in expressional behaviours; impairment in personal hygiene; urinary and fecal incontinence) along with a family history of dementia. The neurological examination and routine electroencephalogram (EEG) of the patient were normal. His cranial magnetic resonance imaging (MRI) revealed asymmetric atrophy, particularly in the right hemisphere at the dorsolateral and orbitofrontal regions. Tc-99 HMPAO single photon emission tomography (SPECT) detected asymmetric hypoperfusion within an extended region, including the right frontal and parietal lobes. There was deficiency in frontal executive functions. Partial improvement in behavioral symptoms was achieved by treating the patient with quetiapine 300 mg/day. The present case study showed that detailed history, as well as medical examination including physical and neurological examination and brain imaging, must be performed in the case of middle-aged patients with insidious onset of psychiatric symptoms.Öğe Job satisfaction and perceived job stress of the health professionals and the relationship between them(CUMHURIYET UNIV TIP FAK PSIKIYATRI ANABILIM DALI, 2013) Ersan, Etem Erdal; Yildirim, Gulay; Dogan, Orhan; Dogan, SelmaObjective: The main purpose of the study is to evaluate the job satisfaction and stress of the health professionals working in a state hospital according to their sociodemographic characteristics and to reveal whether there are any relations between them. Methods: Data have been obtained by means of a form including Minnesota Job Satisfaction Scale, Perceived Job Stress Scale and sociodemographic variables on totally 180 health professionals who are employed in Sivas Numune Hospital. Findings: In our study, it was evaluated that the job satisfaction points of the males were higher when compared to females, those of post-graduates were higher than those of graduates and undergraduates and those of doctors were higher than those of nurses in a statistically important level. The external satisfaction points of the group over 45 when compared to that of the group under 34 and those of other health professionals when compared to nurses were found to be statistically higher. It was found that job stress points of women were higher compared to males, those of the graduates of secondary education, undergraduates and graduates were higher than those of postgraduates, and the job stress points of the nurses were higher than those of doctors and other health professionals. There is a meaningful negative correlation between job satisfaction and job stress. No statistically important difference was found with reference to their marital status, whether they have children and their work years. Results: In our study, job satisfaction and job stress of the health care professionals were studied sociodemographically. In healthcare institutions, besides the satisfaction of the patients, it is also important to deal with and find solutions to the problems of the health care personnel for the establishment of job satisfaction and eliminate job stress.Öğe The mental status, functional levels, and related factors of patients discharged from a psychiatric clinic in Sivas, Turkey(CUMHURIYET UNIV TIP FAK PSIKIYATRI ANABILIM DALI, 2009) Anlar, Leyla; Dogan, Selma; Dogan, OrhanObjective: In Turkey, the number of studies related to the problems, the functional levels, and last psychiatric status of discharged patients from a psychiatric unit is few. The aim of this study was to assess the levels of functional and psychiatric symptoms. Methods: Between the years 2000-2007, there were 816 patients who live in Sivas and who were discharged from Cumhuriyet University Hospital Psychiatric Clinic according to hospital registrations. Data were collected on 343 subjects by interviewing with their homes. The Personal and Disease Characteristic Information Form, Specific Level of Functioning Scale, and the Brief Symptom Inventory were used as the tools of data collection. The Student's t test, ANOVA, Pearson's correlation analysis was used in statistical analysis of data. Results: While 38.8% of the patients were continuing their treatments and their relationship with the institution, 17.5% had stopped their treatment based on the doctor's decision. In general, the level of functioning of the patients was found as satisfactory, the lowest level functioning score was in patients with schizophrenia. The level of functioning score was lower in the patients who were not working, had been admitted in the last two years and four or more times to the hospital, and in women. The Brief Symptom Inventory mean scores of patients were found to be as 0.98. These scores were higher in patients had been admitted four or more times to the hospital, had not taking responsibility, irregularly kept their appointments, had taken their medication irregularly, not satisfaction taking drug, had anxiety disorders, and in housewives than the other groups. Conclusion: According to these results, it is necessary for the patients with severe psychiatric disorders to be monitored and to be supported after discharge. (Anatolian Journal of Psychiatry 2009; 10: 293-300)Öğe Potential Risk Factors for Schizophrenia(GALENOS YAYINCILIK, 2010) Akal, Burcin N.; Dogan, OrhanObjective: Schizophrenia is a serious mental illness that affects the individual in various ways. Many risk factors have been suggested in the emergence of the illness. The aim of this study is to identify the potential risk factors for schizophrenia considering the characteristics of patients. Methods: The study included 164 patients diagnosed with schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic criteria and a control group consisting of a matching number of healthy people. The subjects were given questionnaire forms on potential risk factors (prenatal and postnatal, sociodemographic, illness-related information). Student's t-test, chi-square test and logistic regression analysis were used to evaluate the data. Results: Significant differences were identified between the patient group and healthy control group in terms of: for the mother-use of medication, history of inflammatory disease, or a psychical or physical trauma during pregnancy; -for the patient-being born in hospital, prolonged delivery, growth during childhood, relatives with a history of schizophrenia, and school history. Among the subtypes of schizophrenia, significant differences were identified in terms of educational level, birth rank and school history. Conclusion: Identification of the potential risk factors for schizophrenia and of subjects at risk will provide important individual and social advantages, such as social health, health expenses and protection of individuals and society from the adverse effects of schizophrenia. (Archives of Neuropsychiatry 2010;47:230-6)Öğe Prevalence of anxiety disorders among elderly people(WILEY, 2009) Kirmizioglu, Yalcin; Dogan, Orhan; Kugu, Nesim; Akyuz, GamzeObjectives The objectives of this study are to determine current and lifetime prevalence of anxiety disorders and also to explore the relationship, if any, between possible risk factors and anxiety disorders, amongst elderly people living in the Sivas province of Turkey. Methods The research sample consisted of 462 persons. A Socio-demographic Data Form was given to the participants and the Anxiety Module of SCID-I was applied. Chi-square and Fischer's exact tests were used to evaluate the data obtained. Results The current prevalence for all types of anxiety disorder was found to be 17.1% overall and the lifetime prevalence was found to be 18.6%. The current prevalence rates for particular disorders were found to be 0.4% for panic disorder, 3.2% for obsessive-compulsive disorder, 1.9% for post-traumatic stress disorder, 2.8% for social phobia, 11.5% for specific phobia, 6.9% for generalized anxiety disorder (GAD). Lifetime prevalence rates for these disorders (except GAD) were 1.1%, 3.2%, 3.0%, 2.85%, 11.5% respectively. Conclusions Anxiety disorders are more common among elderly people than was previously thought. The lifetime prevalence of specific phobia amongst the elderly is higher than that of general population; the lifetime prevalence ratios of obsessive-compulsive disorder and social phobia are similar to that of the general population in Sivas. In order to improve the delivery of health services, it is recommended that further studies should be conducted among elderly people, both by applying standardized diagnostic tools, but also taking into account socio-economic factors and using convenient therapy methods developed specifically for this group. Copyright (C) 2009 John Wiley & Sons, Ltd.Öğe Prevalence of attention-deficit/hyperactivity disorder and co-morbid disorders among students of Cumhuriyet University(EUROPEAN JOURNAL OF PSYCHIATRY, 2012) Kavakci, Onder; Kugu, Nesim; Semiz, Murat; Meydan, Feride; Karsikaya, Sureyya; Dogan, OrhanBackground and Objectives: Most of the previous studies investigated prevalence of attention-deficit/hyperactivity disorder (ADHD) among university students with self report measures. Present study investigated actual prevalence of ADHD and comorbid disorders among university students in Cumhuriyet University of Sivas in Turkey. Methods: In the first stage, 980 university students filled in the Adult ADHD Self-Report Scale and socio-demographic form, 79 of whom were above the cut-off score of Adult ADHD Self-Report Scale, considered as possible ADHD. They were evaluated in the second stage via structured interview SCID I, SCID II, Adult ADHD Module of MINI Plus. In addition, subjects filled in the self report Adult ADD/ADHD DSM IV-Based Diagnostic Screening and Rating Scale. Results: The self report ADHD prevalence rate was 10.1% and the actual prevalence rate of ADHD among the university students was calculated 6.1%. The prevalence of ADHD was greater among male than female (7.0% vs. 5.5%). Among the male students inattentive subtype was 1.6%, hyperactive-impulsive 0.24%, combined 5.1%. Female students were found to be inattentive by 1.45%, hyperactive-impulsive by 0.56% and combined type by 3.48%. Most of the students with ADHD had Axis I (especially depressive disorders) and Axis II disorders (especially cluster B personality disorders). ADHD diagnosis was associated with more cigarette and alcohol use, academic failure, legal problems, somatic complaints and suicide attempts. Students with ADHD were spending more time on the Internet than students without ADHD. Only one student diagnosed with ADHD reported to have had previous ADHD diagnosis. Conclusions: ADHD is common among university students. Having a diagnosis of ADHD in early adulthood seems to be associated with psychological, social, and academic problems.Öğe The probable learning disorders in primary school students: A preliminary study(CUMHURIYET UNIV TIP FAK PSIKIYATRI ANABILIM DALI, 2009) Dogan, Orhan; Ersan, E. Erdal; Dogan, SelmaObjective: The diagnostic criteria to determine the prevalence of learning disorders (LD) via a scale are not clear. Therefore, the true prevalence rates of LD are not known. The aim of this research was to determine the ratio of probable LD in primary school students according to Silver's diagnostic criteria for LD, in Sivas province. Methods: The research population included all of the first level of primary school students (first to fifth grade) in Sivas province; there were 26843 students at 65 primary schools. The sample was made up of 1340 students between 7 and 12 years old in the nine schools that were chosen. The schools in Sivas province were listed in order one under the other, and were selected for the study at random. Then, the classes were also selected randomly. The teachers and parents of the students were given questionnaire form. This form had demographic characteristics and Silver's diagnostic criteria for LD. A student was evaluated, as "there is a probable learning disorder" if more than half of the answers to questions is negative. The forms were evaluated if both the teachers and parents completed the form fully. The number of evaluated forms was 845 and response rate 63.06%. Chi-square test was used to evaluate the data by SPSS 13.0 for Windows package program. Written informed consent to participate in the study was obtained from the parents of all respondents. Results: The ratio of probable LD (pLD) was found to be 36.8% according to the evaluations of teachers, 37.9% according to the evaluations of parents. The ratio of probable reading disorder (pRD) according to the evaluations of teachers was found to be 18.8%, 18.0% for probable written expression disorder (pWED), 24.1% for probable mathematics disorder according to the evaluations of teachers; and according to the evaluations of parents 26.5%, 6.0%, 21.5%, respectively. The difference between the ratio of pRD and pWED was statistically significant. In the evaluations of teachers and parents, the ratio of pRD was found higher in boys than girls. The highest rate of pLD was found in seven years olds and first graders at both evaluations of teachers and parents. However, the ratio of teachers was higher almost two-fold than those of parents. Discussion: The ratio of pLD in this research was higher than the ratio of LD in literature. The ratios given in literature are related to LD, but pLD our ratios. The clear definition of LD and diagnostic criteria should be establihed to develope a standard, valid, and reliable scale that could be used in the prevalence studies with larger samples. (Anatolian Journal of Psychiatry 2009; 10: 6270)Öğe Prostaglandin metabolite levels in patients with schizophrenia(CUMHURIYET UNIV TIP FAK PSIKIYATRI ANABILIM DALI, 2011) Ersan, E. Erdal; Ersan, Serpil; Dogan, OrhanObjective: Schizophrenia is a neuropsychiatric disease which affects individuals, family members and society. Although many studies have been carried out on the etiopathogenesis of schizophrenia, the condition is not entirely understood. In this study, it has been aimed to measure prostaglandin (PG) metabolite levels in patients with schizophrenia. Methods: The present study measured prostaglandin metabolite levels in 50 schizophrenia patients and 50 healthy volunteers who were matched for age, sex and smoking is similar in terms of, at least two years of patient. Measurements were also taken of 13,14-dihydro-15-keto-PGF(2 alpha) (PGFM) and 13,14-dihydro-15-keto PGE(2) (PGEM). The measurements were performed using High Performance Liquid Chromatography (HPLC) which is a more sensitive device. Statistical analysis of the data was performed using Student's t Test, Chi Square Test, Kruskal-Wallis Test and Mann-Whitney Test. Findings: In the patient group, the PGEM level (0.0807+/-0.014, t=3.490, p=0.001) and the PGFM level (0.0613+/-0.0128, t=-7.486, p=0.000) were both significantly lower than in the control group (PGEM 0.0907+/-0.0146; PGFM 0.0793+/-0.0113). Discussion: These results suggest that a disorder in phospholipid metabolism may be important in the etiopathogenesis of schizophrenia. (Anatolian Journal of Psychiatry 2011; 12:100-106)Öğe Psychosis Association with Graves Thyrotoxicosis: A Case Report(UNIVERSITATSVERLAG ULM GMBH, 2008) Kugu, Nesim; Dogan, Orhan; Topcu, Omer; Kavakci, Onder; Karsikaya, SureyyaGraves disease is ail autoimmune and multifactorial disease of the thyroid gland and one of the commonest reasons of the hyperthyroidism. Most of the Graves disease patients show typical symptoms of the disease such as fatique, irritability, weight loss, palpitations and heat intolerance. Mental abnormalities are also known to be present in case of Graves thyrotoxicosis. These mental abnormalities are composed of irritability, emotional lability, anxiety, depression, mania, and psychotic manifestations with paranoid and persecutive delusions. Here we presented a 38 year old woman having Graves thyrotoxicosis who had no psychiatric disorder or a history of any medical illness before Graves thyrotoxicosis but whenever the disease had started acutely patient presented some psychotic symptoms such as hallucinations, paranoid and persecutive delusions, a state of confusion, agitation and hyperactivity. In the first thyroid function test (TFT) blood thyroid hormone levels were found as follows: free T(3) (FT(3))= 8.07 pg/ml (normal value: 1.71-3.71), free T(4) (FT(4))= 1.46 ng/dL (normal value: 0.70-1.48) and TSH<0.0008 (normal value: 0.35-4.94). Patient was diagnosed as Graves thyrotoxicosis after the results of her past history, physical examination, laboratory and clinical findings and patient was given antithyroid treatment. Additionally patient was also given antipsychotic treatment to control her psychotic symptoms. After the treatment psychotic and clinical symptoms of the patient relieved significantly. The case presented here showed that Graves thyrotoxicosis may start with acute psychotic symptoms and this condition may frequently be misdiagnosed with major psychiatric disorders. So, in the presence of the clinical cases which starts with acute psychotic symptoms, it is very important to get detailed medical and psychiatric past history, to make carefull physical examination and to make detailed medical investigations including thyroid function tests.Öğe Psychotic mania associated with hypothyroidism: a case report(YERKURE TANITIM & YAYINCILIK HIZMETLERI A S, 2015) Yontar, Gozde; Semiz, Murat; Kugu, Nesim; Dogan, Orhan; Kavakci, OnderThyroid hormone abnormalities may be associated with various psychotic disorders and mood disorders. A well-known relationship between mania and hyperthyroidism exists in the literature, whereas mania associated with hypothyroidism is rare. In this paper, we present a female patient diagnosed with hypothyroidism due to her noncompliance to thyroid hormone replacement therapy after total thyroidectomy and had comorbid psychotic mania with the symptoms including insomnia, irritability, increase in religious activities, visual and auditory hallucinations, and increased and aimless speech. The patient was effectively treated with the combination of thyroid hormone replacement therapy and antipsychotic treatment. In conclusion, regardless of their age all patients with psychiatric disorders should be examined for any thyroid hormone abnormalities; particularly those showing sudden onset of illness without any personal or familial psychiatric disorder history.Öğe Resistant obsessive compulsive disorder and treatment alternatives(CUMHURIYET UNIV TIP FAK PSIKIYATRI ANABILIM DALI, 2010) Dogan, OrhanObsessive compulsive disorder is an anxiety disorder that is characterized with obssessions and/or compulsions, causes disability, and impairs the quality of life. It has chronic course and a recurrent characteristic. The ratio of patients with resistant obsessive compulsive disorder is relatively high. Resistance is defined as that is no response in spite of using in maximum dosage and enough duration at least two serotonin reuptake inhibitors or two antidepressants from different groups or clomipramine and a serotonin reuptake inhibitor. The ratio of response to first line drugs is between 40% and 60%. In resistant patients, the diagnosis, the former treatments, compliance to treatments, comorbidity must be carefully evaluated. The treatment alternatives include changing drug, augmentation with cognitive behavior therapy, the combination of two serotonin reuptake inhibitors, the using intravenous serotonin reuptake inhibitors (clomipramine, citalopram), the augmentation treatments (the other antidepressants, antipsychotics, mood stabilizers, glutamatergic agents, benzodiazepines), alternative monotherapies (MAOls, venlafaxine, sumatriptan, glutamatergic agents, psychostimulants, buspirone, tramodol). The other treatment alternatives except for drug treatments are cognitive behavior therapy, electroconvulsive therapy, transcranial magnetic stimulation, deep brain stimulation. Psychosurgery is the last alternative in resistant patients with nonresponsive to any treatment. The benefits of alternative treatments except for drug treatments and cognitive behavior therapy is not definite. (Anatolian Journal of Psychiatry 2010; 11:269-278)Öğe Serum cortisol and dehydroepiandrosterone-sulfate levels in schizophrenic patients and their first-degree relatives(WILEY-BLACKWELL, 2011) Yildirim, Osman; Dogan, Orhan; Semiz, Murat; Kilicli, FatihAims: Alterations in cortisol and dehydroepiandrosterone sulfate (DHEA-S) levels are thought to play a role in the pathophysiology of neuropsychiatric disorders, including schizophrenia. The aim of this study was to investigate the role of serum cortisol and DHEA-S in the pathophysiology of schizophrenia. Methods: Sixty schizophrenic patients, 70 healthy first-degree relatives, and 60 healthy volunteers were included. Sociodemographic characteristics, data regarding disease duration and severity, as well as ongoing and previous drug use were recorded. Serum cortisol and DHEA-S levels were measured. Results: Serum cortisol and DHEA-S levels were significantly higher in the schizophrenia group compared with the first-degree relatives and controls (P < 0.05). Serum cortisol levels in the first-degree relatives were significantly higher than in the healthy controls (P < 0.05). There was no significant difference between the first-degree relatives and healthy-controls in terms of DHEA-S levels and between the three groups in terms of serum cortisol/DHEA-S ratios. Conclusions: Elevated serum cortisol levels in schizophrenic patients might be associated with the role of cortisol in the pathophysiology of schizophrenia. Also, the elevation of serum cortisol levels in first-degree relatives compared to controls suggests that similar pathophysiological processes might have a role in individuals without any disease symptoms, but with a genetic predisposition for schizophrenia. Elevated serum DHEA-S levels might be the result of a compensatory response to elevated cortisol levels. Serum cortisol and DHEA-S levels may be used as a biological marker for the diagnosis of schizophrenia; however, further studies with larger sample sizes are warranted to support this finding.Öğe Social Phobia Among University Students and Its Relation to Self-Esteem and Body Image(CANADIAN PSYCHIATRIC ASSOC, 2004) Izgic, Ferda; Akyuz, Gamze; Dogan, Orhan; Kugu, NesimObjective: To demonstrate the prevalence of social phobia and its relation to body image and self-esteem. Method: Study participants were 1003 students recruited from Cumhuriyet University as a randomized sample. Subjects were administered the Diagnostic Interview Schedule-III-Revised (DIS-III-R) Social Phobia Scale, the Rosenberg Self-Esteem Scale, and the Multidimensional Body-Self Relations Questionnaire (MBSRQ). We analyzed the data, using Fisher's exact chi-square test. Results: Lifetime prevalence of social phobia among university students was 9.6% and past-year prevalence was 7.9%. Self-esteem was lower (P < 0.05) among those with social phobia than among those without social phobia. Students with social phobia had lower scores on the MBSRQ than did those without social phobia (P < 0.0001). Conclusions: The results show that persons with social phobia have lower self-esteem and more distorted body image than do those without social phobia.Öğe Sociology of mental health and disorders(2006) Dogan, Orhan; Kocacik, FarukPsychiatry and psychiatric disorders are closely related with social sciences through epidemiologic and etiologic characteristics of psychiatric disorders. Sociologists have been determined five basic views about mental health and disorders: social causation, societal reaction, critical theory, social constructivism, and social realism. Sociology consists of social class, gender, age, race and ethnicity, ethical issues, the characteristics of psychiatric therapies, hospitals, and professions. In the last two decades, it could not realize the cooperation between psychiatry and sociology because of psychiatry turn to biomedical model from biopsychosocial model. This cooperation is necessary for development as a scientific discipline of social psychiatry.
