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Öğe A comparison between rate of nonmotor symptom development in essential tremor and Parkinson's disease(Springer Heidelberg, 2015) Sengul, Yildizhan; Sengul, Hakan S.; Sural, Muge Kocak; Bakim, Bahadir; Forta, HulkiIn the last decade our perspective on essential tremor (ET) as a pure motor system disorder has begun to change. By virtue of recent studies of nonmotor symptoms (NMSs) that are used to characterize Parkinson's disease (PD), these symptoms have also been added to the definition of ET. There is increasing evidence to suggest that ET might not be as benign and monosymptomatic as we previously thought. The aim of this study was to evaluate nonmotor symptoms in ET, and to compare them with PD. We studied 37 ET and 23 PD patients. Tremor rate was evaluated using the Fahn-Tolosa-Marin tremor rating scale (FTM-TRS) in ET patients. The patients with PD were scored for motor symptoms using the unified Parkinson's disease rating scale (UPDRS)-III and the Hoehn-Yahr scale. Cognitive functions were assessed with the Montreal Cognitive Assessment (MoCA) test. NMSs were evaluated with the nonmotor symptoms questionnaire (NMSQuest). In the ET group, the most common NMSs were forgetting things, feeling sad, nocturia, urgency, and difficulty concentrating. The mean NMSQuest score was 8.43 +/- 4.14 in the ET group and 14.06 +/- 5.44 in the PD group (p value < 0.001). However, except for 12 items in NMSQuest, in comparing items one by one there was no statistical difference between them. The mean MoCA total score was 17.81 +/- 4.56 in the ET group and 17.08 +/- 4.08 in the PD group (p value 0.675). There were no significant differences in MoCA subgroup scores. Evaluation of nonmotor symptoms in ET may help us to understand this emerging definition of ET. This study contributes evidence toward this new concept.Öğe Adult attention deficit and hyperactivity disorder comorbidity in obsessive compulsive disorder(Informa Healthcare, 2012) Bakim, Bahadir; Ertekin, Hulya; Ertekin, Yusuf; Karamustafalioglu, Oguz[Anstract Not Available]Öğe Can obsessive compulsive disorder be detected in adolescent population with three-point scanning?(Aves Press Ltd, 2013) Akpinar, Abdullah; Alpak, Gokay; Cevik, Mehmet; Bakim, Bahadir; Goksan, Burcu; Yumrukcal, Huseyin; Ertekin, HulyaObsessive compulsive disorder (OCD) has been reported in adolescent population commonly. Adolescents with OCD seek for treatment usually when their functionality has been destroyed significantly. Therefore scanning OCD in adolescent population is very important. In this study, we aimed to evaluate the sensitivity, specifity, and predictability of the self reported three points scanning which can be fulfilled easily and fast The study sample comprises of a total 177 high school first class students whose ages are between 14-17 years old The results of OCD module of Structured Clinical Interview for DSM-IV Axis I and the estimated results of three item Obsessive Compulsive scale derived from self reported Child Adolescent Behavior Assessment Scale have been compared. The OCD prevalence (at the moment) was 2.8% when calculated for structured interview. Potential OCD was 46% when calculated for Obsessive Compulsive Scale scanning The sensitivity of three item CABAS-OCS was 60%, its specifity was 54%, positive predictive value 4%, and negative predictive value was 97%. Eventually, the sensitivity and specifity of the detection method of OCD by using three item scanning were intermediate Its discrimination of non-OCD adolescents was satisfactory. Despite that positive prediction power was low and so this method should be redeveloped.Öğe Cognitive functions, fatigue, depression, anxiety, and sleep disturbances: assessment of nonmotor features in young patients with essential tremor(Springer Heidelberg, 2015) Sengul, Yildizhan; Sengul, Hakan S.; Yucekaya, Sevda K.; Yucel, Selma; Bakim, Bahadir; Pazarci, Nevin K.; Ozdemir, GokhanThere is a growing amount of evidence to suggest that besides motor features, patients with essential tremor (ET) may exhibit significant nonmotor features, such as mild cognitive deficits, fatigue, neuropsychiatric symptoms, and sleep disturbances. The goal of this study was to examine nonmotor features in young patients with ET and their impact on quality of life. 45 patients (24.55 +/- 7.16 years old) with ET and 35 controls were evaluated using the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Beck Depression Inventory, Beck Anxiety Scale, Fatigue Severity Scale, and Short Form-36. Cognitive functions were evaluated using the Turkish version of the Montreal Cognitive Assessment Battery (MoCA). We ruled out other possible causes of the tremor. The tremor rate was evaluated using the Fahn-Tolosa-Marin Tremor Rating Scale. Poor sleep quality, fatigue, anxiety, and depressive symptoms were more common, and MoCA total scores were lower in the patient group. Fatigue, depressive symptoms, and higher anxiety levels were seen to have a negative effect on physical and mental health. Excessive daytime sleepiness had a negative effect on physical health. There is an emerging interest in nonmotor features of ET. This study showed that even young patients have nonmotor features that decrease their quality of life. This might tell us that nonmotor symptoms could be a part of the disease in the early stages.Öğe Depression and anxiety disorder comorbidity in patients with obstructive sleep apnea syndrome (OSAS)(Informa Healthcare, 2012) Bakim, Bahadir; Ertekin, Hulya; Karamustafalioglu, Oguz; Tekin, Atilla; Yavuz, Burcu Gokasan; Yayla, Sinan[Anstract Not Available]Öğe Efficacy of High Frequency [10 Hz] Repetitive Transcranial Magnetic Stimulation of the Primary Motor Cortex in Patients with Fibromyalgia Syndrome: A Randomized, Double Blind, Sham-Controlled Trial(Informa Healthcare, 2014) Tekin, Atilla; Ozdil, Esra; Guleken, Mehemet Diyaddin; Iliser, Resat; Bakim, Bahadir; Oncu, Julide; Cevik, MehmetObjectives: Repetitive transcranial magnetic stimulation [rTMS] of the cerebral cortex has been tested as a treatment tool for various neurological and psychiatric diseases and other painful disorders. Our objectives were to determine whether high-frequency rTMS applied to the primary motor cortex could decrease pain intensity and influence the quality of life in patients with fibromyalgia syndrome [FMS]. Design: Fifty two patients with FMS were randomized to real [n = 27] or sham [n = 25] treatment groups. Ten consecutive sessions of rTMS were given to each of the patients. All patients were evaluated with the Structured Clinical Interview from the Diagnostic and Statistical Manual of Mental Disorders before treatment. The level of pain and the mood status were assessed with a visual analog scale and the Montgomery Asberg Rating Scale, respectively. The Turkish version of the World Health Quality of Life-BREF instrument was used to evaluate the quality of life. Results: The decrease of pain scale scores was found to be significantly greater among the real rTMS group than among those in the sham group [p<0.001]. Also the life quality physical subscale score improvement was significantly greater among those in the real rTMS therapy group than among those in the sham treatment group [p<0.001]. A strong relationship was found betweeen the decrease of pain levels in the real rTMS treated patients and the life quality physical subscale score improvement [R-2=0.419 and p<0.001]. Conclusions: These findings suggest that high-frequency rTMS application to the primary motor cortex could have an analgesic effect. Therefore, rTMS may be an alternative therapeutic option in FMS.Öğe Evaluation of Assaults on Doctors in Canakkale within the Last Year(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2014) Karaahmet, Elif; Bakim, Bahadir; Altinbas, Kursat; Peker, EmelObjective: Violence against doctors and health professionals in the healthcare environment is thought to have increased in recent years. Although physical and verbal assaults in the health care system have been evaluated in many different aspects, a limited amount of research has been done in this field in our country. For this reason, we aimed to investigate assaults towards doctors working at the Canakkale State Hospital and Canakkale Onsekiz Mart University in Turkey. Method: A questionnaire was prepared by researchers assessing assaults within the last year on doctors working in the state and university hospitals. Data from 130 doctors who agreed to participation in the study were analysed with SPSS version 16. Descriptive statistics, independent sample T-test for normally distributed variables and Mann-Whitney U test for non-normally distributed variables were used to compare the groups. Results: We found that 59.2% (n=77) of the doctors were verbally and/ or physically assaulted at least once during the past year. The majority of attackers consisted of relatives of patients (40.8% verbal attack, n=31). The verbal assaults mostly occurred in outpatient clinics (61.5%), with half of the physical assaults occurring in the emergency department. The vast majority of doctors considered that poor health policies were the most important reason for assaults (83.3%, n=65), and nearly all of them thought that violence towards doctors has increased in recent years (97.4%). Conclusion: The fact that most of the doctors exposed to assaults, regardless of gender, institution, or work position, perceived health policies as being responsible for this violent atmosphere, is very striking. We believe that larger sample-size and comprehensive countrywide studies in this area would help to provide solutions for this problem.Öğe Letter to the editor: A common phenomenon in psychiatry: Yawning'(Turkish Association of Nervous and Mental Health, 2013) Öyekçin, Demet Güleç; Bakim, Bahadir; Aydin, Pinar Çetinay[No abstract available]Öğe Mania with Psychotic Feature Induced by the use of Pramipexole in Parkinson's Disease: A Case Report(Turkiye Sinir Ve Ruh Sagligi Dernegi, 2014) Meric, Ceren; Pirdogan, Efruz; Toker, Omur Gunday; Tekin, Atilla; Bakim, Bahadir; Celik, SelimeParkinson's disease, a neurodegenerative disorder characterized by movement abnormalities, is frequently complicated by psychiatric syndromes. Psychiatric symptoms may be the direct result of PD, its co-morbid pathologies, or occur as a side effect of its pharmacotherapy. Pramipexole, like other dopamine agonists for treating Parkinson's disease, has a tendency to induce psychotic and manic symptoms due to central dopaminergic stimulation. In this article, mania with psychotic feature induced by the use of dopamine agonists which is not observed frequently in the literature will be discussed.Öğe Mania with psychotic feature induced by the use of pramipexole in Parkinson's disease: A case report(Turkish Association of Nervous and Mental Health, 2014) Meriç, Ceren; Pirdogan, Efruz; Günday Toker, Ömür; Tekin, Atilla; Bakim, Bahadir; Çelik, SelimeParkinson's disease (PD), which is frequently accompanied by psychiatric symptoms, is a neurodegenerative disease characterized by movement disorders. Psychiatric symptoms may be the direct result of PD, comorbid pathologies, or its pharmacotherapy. Pramipexole, as other dopamine agonists used in the treatment of PD, has a tendency to induce psychotic and manic symptoms due to central dopaminergic stimulation. Herein we present a PD patient that had mania with psychotic feature due to dopamine agonist treatment, which is not commonly reported.Öğe Psychiatric Comorbidity in Patients with Conversion Disorder and Prevalence of Dissociative Symptoms(Routledge Journals, Taylor & Francis Ltd, 2015) Yayla, Sinan; Bakim, Bahadir; Tankaya, Onur; Ozer, Omer Akil; Karamustafalioglu, Oguz; Ertekin, Hulya; Tekin, AtillaThe 1st objective of the current study was to investigate the frequency and types of dissociative symptoms in patients with conversion disorder (CD). The 2nd objective of the current study was to determine psychiatric comorbidity in patients with and without dissociative symptoms. A total of 54 consecutive consenting patients primarily diagnosed with CD according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria who were admitted to the psychiatric emergency outpatient clinic of Sisli Etfal Research and Teaching Hospital (Istanbul, Turkey) were included in the study. The Structured Clinical Interview for DSM-IV Axis I Disorders, Structured Interview for DSM-IV Dissociative Disorders, and Dissociative Experiences Scale were administered. Study groups consisted of 20 patients with a dissociative disorder and 34 patients without a diagnosis of any dissociative disorder. A total of 37% of patients with CD had any dissociative diagnosis. The prevalence of dissociative disorders was as follows: 18.5% dissociative disorder not otherwise specified, 14.8% dissociative amnesia, and 3.7% depersonalization disorder. Significant differences were found between the study groups with respect to comorbidity of bipolar disorder, past hypomania, and current and past posttraumatic stress disorder (ps = .001, .028, .015, and .028, respectively). Overall comorbidity of bipolar disorder was 27.8%. Psychiatric comorbidity was higher and age at onset was earlier among dissociative patients compared to patients without dissociative symptoms. The increased psychiatric comorbidity and early onset of conversion disorder found in patients with dissociative symptoms suggest that these patients may have had a more severe form of conversion disorder.Öğe Sleep disturbances and excessive daytime sleepiness in migraine: A comparison between comorbidities and disability(Springer London Ltd, 2015) Sengul, Yildizhan; Sengul, Hakan S.; Bakim, Bahadir; Yucekaya, Sevda K.; Yucel, Selma; Akgun, MucellaMany studies have investigated the association between headache and sleep disorders, but few have focused on migraine. The goal of this study was to evaluate sleep disturbance and excessive daytime sleepiness (EDS) in relation to migraine disability. 120 migraine patients who were diagnosed according to The International Classification of Headache Disorders-II and 45 healthy controls were recruited for the study. All participants completed the Pittsburg Sleep Quality Index (PSQI), the Epworth Sleepiness Scale, Beck Depression Inventory and Beck Anxiety Scale. Migraineurs completed Migraine Disability Assessment Scale (MIDAS) and Visual Analog Scale. The prevalence of poor sleep was 83.3% in the patients and 22.2% in the controls. All PSQI subgroup scores were higher for the patients than the controls except Hours asleep. EDS was more prominent in the patient group (19.2% vs 2.2%). In conclusion, sleep disturbance, EDS, anxiety, and depressive symptoms were detected more commonly in migraine patients and were correlated with the migraine-related disability. The results of multivariate regression analysis indicated that EDS and sleep disturbance were the most effective factors on disability.Öğe Winter Sale on Lithium Levels: The Impact of Seasonality(Kure Iletisim Grubu A S, 2013) Bakim, Bahadir; Karaahmet, Elif; Altinbas, Kursat; Oral, TimucinObjective: Lithium is recognized worldwide as an effective prophylactic agent in mood disorders. Prophylactic efficacy of lithium in mood disorders has been established since the early seventies. Lithium has been and continues to be the mainstay of bipolar disorder (BD) pharmacotherapy for acute mood episodes, switch prevention, and suicide prevention. There are reports of seasonal variation in lithium levels from a few countries. Variability in the lithium level can lead to a lack of efficacy or to toxicity, making seasonal variation clinically relevant. We aimed to compare lithium levels of bipolar patients between summer and winter. Methods: Euthymic bipolar patients who were followed in the Rasit Tahsin Mood Clinic of the Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery were recruited for the study, and lithium levels were measured in the second part of winter and summer (15th of June to 1st of September and 15th of January to 1st of March). A prospective case sheet audit was performed for 32 BD patients for recording plasma lithium level, age and gender for one year. Bipolar patients whose treatment dosage of lithium was changed for any reason during the study follow-up were excluded. Situations of lithium use other than for bipolar disorder were excluded. The presence of concomitant diagnoses of mental retardation or drug dependence constituted exclusion criteria, as did medication non-compliance detected by persistently low lithium plasma levels. The use of antihypertensive drugs, nonsteroidal anti-inflammatory drugs, theophylline, some antibiotics, topiramate, and diuretics that could cause an increase in plasma concentrations of lithium, and of theophylline that could reduce lithium concentrations constituted exclusion criteria. Sodium levels were also monitored due to their propable effect on lithium levels. Lithium levels were compared using the paired sample t-test. Correlation analysis was done for the parameters that could affect lithium levels. Results: The mean age of the patients was 35.75 +/- 9.59 years, the mean age of onset was 21.97 +/- 6.17 and the mean duration of disorder was 13.90 +/- 9.41 year. 15 out of 32 patients were male. The overall average dose of lithium taken by the patients was 1190.6 +/- 249.0 mg/day. The mean lithium plasma level was 0.75 +/- 0.12 mEq/L in winter, and the mean lithium plasma level was 0.83 +/- 0.12 mEq/L in summer (p=0.003). The overall serum sodium levels were 139.1 +/- 2.2 mEq/L in summer and 137.1 +/- 2.3 mEq/L in winter (p=0.001). The correlation between lithium and sodium levels was not significant in summer or in winter (respectively p=0.55, r=0.12 and p=0.49, r=0.14). Conclusions: The present study showed a significant variability of lithium levels when comparing summer and winter. Therefore, frequent plasma level monitoring and oral lithium dose adjustment to prevent situations of toxicity or lack of efficacy in bipolar disorder are suggested. Lithium levels may show a relative increase in summer due to dehydration. Prospective controlled studies are required to differentiate whether this seasonality is specific to bipolar disorders or not.
