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Öğe A case with manic delirium(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2014) Mert, Derya Guliz; Kavakci, Onder; Semiz, Murat; Kugu, Nesim; Yonel, EceManic delirium is defined as co-occurrence of mania and delirium. Publications are referred to case reports. In this study, we describe a 63 years old woman with signs and symptoms of delirium and suffering from bipolar disorder. Mania symptoms were not observed during her first evaluation and monitoring. There was no toxic or medical condition that explained the delirium seen. Manic delirium seems to be an acute and severe form of bipolar disorder, which can be treated with (responsive to) antipsychotics and mood stabilizers. Manic delirium should be kept in mind as a diagnosis for the patients who present with delirium and has no organic cause to explain it.Öğe ASSOCIATES OF ADULT SEPERATION ANXIETY DISORDER AMONG UNIVERSITY STUDENTS: A CASE CONTROL STUDY(Dokuz Eylul Univ Inst Health Sciences, 2022) Bozkir, Tugba; Yilmaz, Nuryil; Kugu, NesimPurpose: Separation anxiety is a state of extreme anxiety, felt by an individual in case of separation from attachment figure. It was aimed to investigate attachment styles, temperament traits, childhood trauma and dissociative experiences of university students diagnosed with adult separation anxiety disorder (ASAD). Methods: Sixty five university students, diagnosed to have ASAD by a structured clinical interview were compared with healthy students via Adult Attachment Style Questionnaire (AAQ), Childhood Trauma Questionnaire (CTQ), Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto questionnaire (TEMPS-A), and Dissociative Experiences Scale (DES). Results: Twenty two (33.8%) students with ASAD had problems with orientation and getting used to university. According to AAQ, students with ASAD had higher prevalence of insecure attachment styles, and especially high ambivalent attachment styles and to CTQ, students with ASAD had significantly higher scores in all subscales except physical abuse. Overall DES score was higher in students with ASAD compared to the control group. DES score and history of physical disease in the family were independent associates of ASAD. Conclusion: Dissociative experiences and history of physical disease in the family were independent associates of ASAD among university students. Hence, early awareness of dissociative symptoms and family history might help early identify students with ASAD.Öğe Associates of Adult Seperation Anxiety Disorder among University Students: A Case Control Study(Dokuz Eylül Üniversitesi, 2022) Bozkir, Tugba; Yilmaz, Nuryil; Kugu, NesimPurpose: Separation anxiety is a state of extreme anxiety, felt by an individual in case of separation from attachment figure. It was aimed to investigate attachment styles, temperament traits, childhood trauma and dissociative experiences of university students diagnosed with adult separation anxiety disorder (ASAD). Methods: Sixty five university students, diagnosed to have ASAD by a structured clinical interview were compared with healthy students via˝Adult Attachment Style Questionnaire (AAQ)," "Childhood Trauma Questionnaire (CTQ)," "Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto-questionnaire (TEMPS-A)," and "Dissociative Experiences Scale (DES)." Results: Twenty two (33.8%) students with ASAD had problems with orientation and getting used to university. According to AAQ, students with ASAD had higher prevalence of insecure attachment styles, and especially high ambivalent attachment styles and to CTQ, students with ASAD had significantly higher scores in all subscales except physical abuse. Overall DES score was higher in students with ASAD compared to the control group. DES score and history of physical disease in the family were independent associates of ASAD. Conclusion: DES score and history of physical disease in the family were independent associates of ASAD among university students. Hence, early awareness of dissociative symptoms and family history might help early identify students with ASAD.Öğe Axis I dissociative disorder comorbidity in borderline personality disorder and reports of childhood trauma(PHYSICIANS POSTGRADUATE PRESS, 2006) Sar, Vedat; Akyuz, Garnze; Kugu, Nesim; Ozturk, Erdinc; Ertem-Vehid, HayriyeObjective: The purpose of this study was to examine the dissociative disorder comorbidity of borderline personality disorder and its relation to childhood trauma reports in a nonclinical population. Method: In April 2003, 1301 college students were screened for borderline personality disorder using the Structured Clinical Interview for DSM-IV Personality Disorders. The Childhood Trauma Questionnaire and Steinberg's dissociation questionnaires were also administered. During May and June 2003, 80 students with a diagnosis of borderline personality disorder and I I I nonborderline students were evaluated using the Structured Clinical Interview for DSM-IV Dissociative Disorders by an interviewer blind to the diagnosis and scores obtained during the first phase. Results: The prevalence of borderline personality disorder was 8.5%. A significant majority (72.5%; 58/80) of the borderline personality disorder group had a dissociative disorder, whereas this rate was only 18.0% (20/111) for the comparison group (p < .001). Childhood emotional and sexual abuse, physical neglect, and total childhood trauma scores had significant effect for borderline personality disorder (p < .001, p = .038, p = .044, and p = .003, respectively), whereas emotional neglect and diminished minimization of childhood trauma had significant effect for dissociative disorder (p = .020 and p = .007, respectively). Conclusion: A significant proportion of subjects with borderline personality disorder have a comorbid dissociative disorder. Lack of interaction between dissociative disorder and borderline personality disorder diagnoses for any type of childhood trauma contradicts the opinion that both disorders together might be a single disorder. Recognizing highly prevalent but usually neglected Axis I dissociative disorder comorbidity in patients with borderline personality disorder may contribute to conceptual clarification of this spectrum of psychopathology.Öğe Childhood trauma and general cognitive ability: Roles of minimization/denial and gender(ELSEVIER IRELAND LTD, 2016) Mert, Derya Guliz; Kelleci, Meral; Yildiz, Esengul; Mizrak, Ali; Kugu, NesimThe aim of this study was to investigate the effects of minimization and gender on the interaction between childhood trauma and general cognitive ability. The study included 345 students. The data were obtained via an information form, the Childhood Trauma Questionnaire (CTQ), and Raven's standard progressive matrices (RSPM). The mean CTQ total score and the mean sexual abuse, physical, and emotional neglect subscale scores of the male students were significantly higher than those of the female students (p < 0.05). The mean minimization score of the female students was greater than that of the male students (p < 0.05). However, among the female students with minimization scores of 3, there was a moderate and significant negative correlation between the CTQ and RSPM scores (r=0.533, p < 0.05). This study found that general cognitive ability was influenced by childhood trauma among female students with higher minimization/neglect scores. The results of the current study suggest that ignoring the effects of minimization may be a misleading factor for determining the gender ratio of childhood trauma and evaluating its effect on long-term cognitive functions. (C) 2016 Elsevier Ireland Ltd. All rights reserved.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 Executive Functions, Intellectual Capacity, and Psychiatric Disorders in Adults with Type 1 Chiari Malformation(Elsevier Science Inc, 2022) Yilmaz, Yavuz; Karademir, Mustafa; Caygin, Tulay; Yagcioglu, Oguz Kaan; Ozum, Unal; Kugu, NesimOBJECTIVE: Contrary to popular belief, the cerebellum is involved not only in motor planning, balance, and coordination but also in cognitive processes. The present study aimed to investigate executive functions (EFs), intellectual capacity, and psychiatric disorders in adults with type 1 Chiari malformation, which is defined as a hindbrain anomaly that involves the cerebellum. METHODS: The study included 62 adults, with 29 in the CM group and 33 in the control group. EFs were evaluated using the Stroop test, number sequence learning test, and standardized mini-mental state examination (SMMSE). The intelligence quotient (IQ) was measured using the Kent EGY and Porteus maze tests, and psychiatric disorders were evaluated using the Structured Clinical Interview for DSM-5, Clinician Version (DSM-5-CV). RESULTS: The CM group took longer than the control to complete the Stroop test for each section (P < 0.005). Although the mean IQ scores of both groups were within the normal range, the CM group had a lower mean IQ score than the control group (P < 0.005). Although the mean SMMSE scores of both groups were within the normal range, the CM group had a lower mean SMMSE score than the control group (P < 0.005). The CM group had a higher rate of psychiatric comorbidities than the control group (P < 0.005). CONCLUSIONS: The study found that subjects with type 1 Chiari malformation performed worse in EFs than healthy controls and had a higher prevalence of psychiatric disorders.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 Increased expressed emotion in patients with psoriasis(TERMEDIA PUBLISHING HOUSE LTD, 2018) Hayta, Sibel Berksoy; Guner, Rukiye; Akyol, Melih; Albayrak, Funda; Kugu, Nesim; Ozcelik, SedatAim of the study: The aim of this study was to determine whether patients with psoriasis are affected by expressed emotion in their family environment. Material and methods: Participants included 62 patients with psoriasis and 83 healthy controls and their biological parent, wife or husband, or adult child as a key relative. Sociodeinographic data were recorded. Psoriasis area severity index was used to evaluate psoriasis severity. Hamilton depression and anxiety scales and the Expressed Emotion Questionnaire form were used to evaluate depression, anxiety, and expressed emotion. Results: The levels of expressed emotion and its subgroups in the patient group were higher than in the group of healthy controls (p < 0.05). Gender, disease duration, disease severity, and key relatives did not affect the levels of expressed emotion (LEEtotal) in the patients with psoriasis (p > 0.05). The LEEtotal of those with low educational level in the patient group was statistically significantly higher than those with higher educational level (p < 0.05). There was no correlation between the presence depression or anxiety and expressed emotion (p> 0.05). There was a negative correlation between age and the levels of expressed emotion in the patient group (p < 0.05). There was a negative correlation between age and intrusiveness in healthy controls (p < 0.05). Conclusions: Although decreasing with age, expression of emotion in patients with psoriasis is high, and psychosocial support should be provided to these patients.Öğe Post-Traumatic Stress Disorder in Migraine Patients: Migraine, Trauma and Alexithymia(GALENOS YAYINCILIK, 2013) Karsikaya, Sureyya; Kavakci, Onder; Kugu, Nesim; Guler, Aysegul SelcenIntroduction: In recent studies, it has been suggested that there is a relationship between migraine headaches and post-traumatic stress disorder (PTSD). The PTSD has not been diagnosed by a clinician in these studies; the evaluation has been carried out by the screening scales. Besides, it has also been asserted that there was relationship of alexithymia with migraine and other chronic painful disorders. In this study, our aim was to investigate the prevalence of clinically-diagnosed PTSD and alexithymic features among migraine patients. Methods: Sixty consecutive migraine patients sent from neurology clinic and 60 healthy controls having similar features constituted the sample of this study. SCID-I/CV PTSD module and the Clinician-Administered PTSD Scale (CAPS) was administered to the sample. The subjects also filled in the socio-demographic data form and the Toronto Alexithymia Scale (TAS). The level of pain perceived by the migraine patients was evaluated using a Visual Analog Scale (VAS). Results: 17 subjects (28%) in the migraine group and 5 individuals (8.3%) in the control group were diagnosed with PTSD. Hence, PTSD was found to be statistically significantly higher in the migraine group. 25 persons in the migraine group (41.6%) and 12 in the control group (20%) scored above the TAS cutoff score in terms of alexithymic features. Alexithymia was found to be statistically significantly higher in the migraine group). In the migraine group, VAS scores of the ones with PTSD were statistically significantly higher compared to that in ones without PTSD. 94% of the persons diagnosed with PTSD in the migraine group reported that their migraine headaches started after a traumatic experience. In the migraine group, no statistically significant correlation was detected between CAPS and VAS scores in subjects with PTSD. Conclusion: In migraine patients, PTSD and alexithymic features have been found higher than in the healthy controls. Further studies are needed to search whether the practices aimed at treating the PTSD and alexithymic features can contribute to the treatment of migraine headaches or not.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 Prevalence of Eating Disorders and Comorbid Psychiatric Disorders in the Sivas Province(TURKIYE SINIR VE RUH SAGLIGI DERNEGI, 2013) Semiz, Murat; Kavakci, Onder; Yagiz, Aysegul; Yontar, Gozde; Kugu, NesimObjective: The purpose of this study was to determine the prevalence of eating disorders (EDs) in the Sivas province, and to identify the sociodemographic characteristics and co-morbid axis-I and axis-II diagnoses in EDs. Method: 1122 people between 18-44 years of age were enrolled in the study after completing the eating attitude test (EAT), and people who had points around the cut-off score had clinical interviews. The control group included subjects that were age- and sex-matched with the ED group, were not diagnosed with an ED, and had an EAT score <30. In order to determine the following as axis I or axis II, SCID-I (Structured Clinical Interview for DSM-IV Axis-I Disorders) and SCID-II (Structured Clinical Interview for DSM-III-R Personality Disorders) were performed on both the eating disorder and control groups. Results: As a result of the scanning done with EAT, we observed that 5.25% of this population might have an eating behavior disorder. The prevalence of the eating disorders was found to be 1.52% by the structured clinical interview in the second step of the study. While the prevalence of bulimia nervosa was determined to be 0.63%, that of binge eating disorder was 0.81%. The diagnosis of ED is common and statistically significant among women (88.2%). According to the study, persons diagnosed with ED were more likely to have a moderate income as compared with those who were not diagnosed with an ED. Also, people with ED had been exposed to more traumas, and it was more likely that someone in their family had a psychiatric diagnosis. Among the patient group, the axis I and axis II co-morbidity rates were significantly higher than those of the control group. 47% (8/17) of the patients were determined to have a co-morbid axis I diagnosis. The most frequently diagnosed co-morbidity was major depressive disorder. 41% of the patients were determined to have an axis II diagnosis. The most common rate of diagnosis was 11.8% for both obsessive-compulsive personality disorder and avoidant personality disorder. Conclusion: The results of this study show that the point prevalence rate for EDs among all the participants was 1.52%, with binge eating disorder being the most prevalent ED. Psychiatric co-morbidity is common in patients with eating disorders. An ED is a disease that can be seen in different age groups and socioeconomic levels. Studies with larger samples, including different regions of the country and different age groups, and with diagnoses that have been confirmed by clinical interviews, are required.Öğe Psychopathology, Family Functioning and Marital Relationship in Female Patients with Fibromyalgia Syndrome(UNIVERSITATSVERLAG ULM GMBH, 2010) Kugu, Nesim; Kaptanoglu, Ece; Kavakci, Onder; Guler, EmelObjective: Fibromyalgia syndrome (FMS) is a chronic widespread painful syndrome of middle-aged women. Psychological problems, especially depression and anxiety are common among the FMS patients. High alexithymia scores have been reported before. It is suggested that FMS has a negative effect on family and marital relationships. In this study, we aimed to search whether there is a difference between the FMS and osteoarthritis patients with chronic pain regarding the psychopathologic features, alexithymia and the effects of these diseases on family and marital relationships. Patients and Methods: Fifty-four female FMS patients and 33 osteoarthritis patients as controls were included in the study. All patients were given a socio-demographic Data Form, Visual Analogue Scale (VAS) for pain, Toronto Alexithymia Scale (TAS), Symptom Check List-90 Revised (SCL-90-R), Marital Life Scale (MLS), Marital Conflict Questionnaire (MCQ), and Family Assessment Device (FAD). Fibromyalgia Impact Questionnaire (FIQ) was given only to the FMS patients. Results: TAS Scale 1 (difficulty in describing the feelings) and TAS total mean scores of FMS patients were significantly higher compared to the control group (p<0.05). The mean scores of SCL-90-R and Global Symptom Index (GSI) subscales, except the paranoid ideation were also significantly higher in FMS group compared to control group (p<0.05). MLS scores were comparable in the FMS and control groups (p>0.05). Regarding MCQ, both Conflict Expansion Score (CES) and Frequency of Conflict Score (FCS) mean values were significantly higher in FMS patients (p<0.05). The mean scores of roles and affective responsiveness subscales of FAD were higher in the FMS group compared to the controls (p<0.05). There were positive correlations between the FIQ scores and obsessive-compulsive (r=0.35, p=0.01), interpersonal sensitivity (r=0.28, p=0.04), depression (r=0.36, p=0.00), anxiety (r=0.41, p=0.00), phobic anxiety (r=036, p=0.00), hostility (r=0.30, p=0.03) and psychoticism (r=0.39, p=0.00) subscales of SCL-90-R. Conclusion: According to the results of our study, there is a "difficulty in describing the feelings" which is an alexithymic component, more general psychopathology regarding SCL-90-R, more conflict in marital relations, and more problems in family functioning especially in areas of affective responsiveness and roles within the family in FMS patients compared to the controls with chronic pain. These findings indicate that multi-dimensional interventions are necessary in the treatment of FMS and instead of concentrating only on chronic pain handling of the family and marital relations negatively affected by accompanying psychopathologic features and disorders of the FMS patients should also be cared.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 The Relationship Between Anger Expression, Body Image and Eating Attitudes in Social Anxiety Disorder(TURKIYE SINIR VE RUH SAGLIGI DERNEGI, 2016) Kartal Yagiz, Aysegul; Kugu, Nesim; Semiz, Murat; Kavakci, OnderObjective: The aim of the present study was to investigate both the prevalence of social anxiety disorder (SAD) and itsassociation of trait anger and anger expression, eating attitudes and body perceptions in university students having the said disorder. Method: One thousand students from Cumhuriyet University were included in the study. During the initial stage, Liebowitz Social Anxiety Scale (LSAS) and socio-demographic data form were administered to the students. Those obtaining 30 points or more in LSAS were called for a psychiatric interview. The students diagnosed with social anxiety disorder (n=87) and the control group (n=87) were administered Eating Attitude Test (EAT), Multidimensional Body-Self Relations Questionnaire (MBSRQ) and The State Trait Anger Scale (STAXI). Results: The point prevalence of social anxiety disorder was found to be 9.4% in those attending the study. Trait anger, anger-in and anger out scores were statistically significantly higher; anger control and multidimensional body-self relations scale points were statistically lower at the SAB group when compared to the control group. The MBSRQ scores correlated negatively, while the EAT scores correlated positively, with anger-in scores in students with SAD. Conclusion: SAD is a common disorder in university students. Our study, showed that repressed anger could adversely affect body image and eating behaviors in SAD. In students having social anxiety disorder, approaches aiming at appropriate anger expression and positive body perception may yield positive results to treatment in students with SAD.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 Trauma and dissociation among prisoners(TAYLOR & FRANCIS AS, 2007) Akyuz, Gamze; Kugu, Nesim; Sar, Vedat; Dogan, OrhanThe current study examined childhood abuse, dissociation and post-traumatic stress disorder ( PTSD) among male prisoners. A sample of 101 randomly selected male prisoners was interviewed. The Dissociative Experiences Scale ( DES), Childhood Abuse and Neglect Questionnaire ( CANQ) and Structured Clinical Interview for DSM-IV (SCID-I)-PTSD module were applied. Probands reported high frequency of criterion A trauma (85.2%) and lifetime PTSD (66.4%). Also, dissociative experiences more frequent than that of general population and most frequent dissociative symptoms were amnesia and absorption. PTSD and childhood traumas occur at high rates in prisoners and this finding has implications for management and treatment.
