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Öğe Facial emotion recognition is associated with executive functions and depression scores, but not staging of dementia, in mild-to-moderate Alzheimer's disease(John Wiley and Sons Ltd, 2024) Buçgün, İsmail; Korkmaz, Şükrü Alperen; Güleç Öyekçin, DemetBackground: Although deficits in facial emotion recognition (FER) significantly affect interpersonal communication and social functioning, there is no consensus on how FER affects Alzheimer's disease (AD). In this study, we aimed to investigate the clinical and neuropsychological factors affecting the possible deficits in the FER abilities of patients with AD. Methods: This cross-sectional study included 37 patients with mild [clinical dementia rating (CDR) scale score = 1] or moderate (CDR = 2) AD, in whom vascular dementia and depression were excluded, and 24 cognitively normal (CDR = 0) subjects. FER ability was determined using the facial emotion identification test (FEIT) and facial emotion discrimination test (FEDT). All participants underwent mini-mental state examination (MMSE), frontal assessment battery (FAB), and geriatric depression scale (GDS). The neuropsychiatric inventory-clinician rating scale (NPI-C), Katz index of independence in activities of daily living, and Lawton instrumental activities of daily living were also administered to patients with AD. Results: The FEIT and FEDT total scores showed that patients with mild and moderate AD had significant FER deficits compared to healthy controls. However, no significant difference was observed between patients with mild and moderate AD in the FEIT and FEDT total scores. FEIT and FEDT scores were not correlated with the MMSE and NPI-C total and subscales scores in patients with AD. Linear regression indicated that FEIT and FEDT total scores were significantly related to age and FAB scores. The GDS score negatively moderated the relationship between FAB and FEDT. Conclusions: This study demonstrated a decreased FER ability in patients with AD. The critical point in FER deficits is the presence of dementia, not the dementia stage, in AD. It has been determined that executive functions and depression (even at a subsyndromal level), which have limited knowledge, are associated with FER abilities.Öğe Prevalence and Influencing Factors of Body-focused Repetitive Behaviors in Turkish Medical Students(2024) Korkmaz, Şükrü AlperenObjective: Body-focused repetitive behaviors (BFRBs) such as skin-picking, trichotillomania, nail- picking, nail-biting, lip-biting and skin-biting have adverse physical and psychological effects. This study aimed to investigate the prevalence and associated factors of BFRBs in a sample of Turkish medical students. Material and Methods: An online survey was used to investigate the prevalence of six BFRBs — skin-picking, trichotillomania, nail-biting, nail-picking, lip-biting and skin-biting-- and psychological factors such as anxiety, depression, stress levels, impulsivity and difficulties in emotional regulation (DER) in a sample of 200 medical students. Skin Picking Scale-Revised (SPS-R), Massachusetts General Hospital Hairpulling Scale (MGH-HPS), Depression Anxiety Stress Scales-21 (DASS-21), Barratt Impulsiveness Scale–Short Form and Difficulty in Emotion Regulation Scale—Brief Form were applied, and specific questions for investigating four BFRBs (nail-picking, nail-biting, lip biting and skin biting) were administered. Results: The prevalence of at least one BFRB disorder was 28.0% (n=56). The most common diagnoses were skin-picking (17.0%) and trichotillomania (10.5%), followed by skin-biting (9.0%), lip biting (8.5%), nail-picking (7%) and nail-biting (5.0%). The gender difference was found only in skin-picking disorders (females=22.9%; males=8.5%). Students with BFRB disorder were found to have higher levels of anxiety, depression, stress, impulsivity and DER. Students in 2nd, 3rd and 5th grade are more likely to have BFRB disorders than interns. The mediation model indicated that DER partially mediates the relationship between impulsivity and the BFRB disorder. Conclusion: The findings of the study suggest that BFRBs are common among medical students and that these behaviors are associated with psychological factors such as depression, anxiety, stress levels, impulsivity and difficulties in emotion regulation. Screening programs and intervention strategies for BFRBs in medical students should be developed, and it is recommended that psychological factors should be considered in these interventions, emotion regulation and stress management skills should be significantly improved, and comorbid depression and anxiety should be treated.Öğe Psychiatric conditions and delirium in hospitalized patients with COVID-19 during the pandemic(2024) Ertekin, Hülya; Kettaş, Erdem; Korkmaz, Şükrü AlperenIntroduction: This study aimed to examine the patients who were consulted to psychiatry while receiving inpatient treatment due to COVID-19 infection based on sociodemographic data, medical history, diagnoses and treatments. Methods: This is a retrospective study in which the consultations were retrospectively reviewed using information obtained from electronic medical records. The consultant psychiatrists created a structured data collection form to evaluate the clinical and demographic features of the patients. Results: Ninety-nine of the psychiatry consultation results of patients were evaluated. The mean age of patients was 64.48 ± 18.82. The most common medical diagnoses are hypertension (n=32, 32.3%) and heart disease (n=21, 21.1%). The most common reason for consultation was agitation (n=27, 27.2%), and the most common diagnosis was delirium (n=25, 25.2%) and anxiety disorders (n=23, 23.2%). Increasing age, presence of hypertension and diabetes mellitus, and oxygen inhalation therapy were factors affecting the diagnosis of delirium. In contrast, the presence of heart disease or diabetes mellitus increased the risk of anxiety disorder, and antipsychotic use decreased this risk. Conclusion: It has been revealed that inpatients with COVID-19 were at risk of psychiatric disorders, especially delirium and anxiety disorders. Psychiatric conditions may notably influence the prognosis and treatment of COVID-19.Öğe Reliability and Validity of the Turkish versions of the Davos Assessment of Cognitive Biases Scale (DACOBS) and Cognitive Biases Questionnaire for Psychosis (CBQp)(Turkish Neuropsychiatry Assoc-Turk Noropsikiyatri Dernegi, 2024) Korkmaz, Şükrü Alperen; Keleş Altun, İlkay; Sağbaş, Serap; Köksalan, Fatmagül Eda; Atagün, Murat İlhanIntroduction: Cognitive biases can be defined as dysfunctional patterns of thought formation that lead to incorrect conclusions and abnormal perceptions and are critical factors in the development and maintenance of psychosis. Two self-report measures assessing cognitive biases in psychosis spectrum disorder (PSD) have recently been developed: the Davos Assessment of Cognitive Biases Scale (DACOBS) and the Cognitive Biases Questionnaire for Psychosis (CBQp). This study aimed to validate the Turkish versions of the DACOBS and CBQp. Methods: The sample consisted of 171 patients with PSD and 162 age and sex-matched healthy controls (HC). We investigated I) the factor structure with confirmatory factor analysis (CFA), II) the reliability (internal consistency and test-retest reliability), III) discriminative power, IV) convergent validity, and V) the concurrent validity of DACOBS and CBQp. Results: The 7-factor solution for DACOBS, similar to the original study, and the 5-factor solution for CBQp provided the best fit. DACOBS and CBQp total and their subscale scores showed good internal consistency and test-retest reliability. DACOBS and CBQp total and their subscale scores could differentiate between PSD patients and HCs when controlling for age, sex, and education. DACOBS and CBQp showed a positively moderate correlation. DACOBS and CBQp scores were associated with psychotic symptoms in PSD patients and positive psychic experiences in HCs. Conclusions: Both the DACOBS and the CBQp have good psychometric properties and are suitable instruments for assessing cognitive biases in the Turkish population. The Turkish versions of the DACOBS and CBQp were as reliable and valid as the original.Öğe Successful treatment of severe alcohol withdrawal delirium with very high-dose diazepam (260-480 mg) administration(Taylor and Francis Ltd., 2024) Korkmaz, Şükrü Alperen; Aldemir, Ebru; Güleç Öyekçin, DemetIntroductionAlcohol withdrawal delirium, commonly known as "delirium tremens (DT)", is the most severe clinical condition of alcohol withdrawal syndrome (AWS). Symptoms of DT include changes in consciousness and cognitive and perceptual impairments that fluctuate during the day. Treatment includes general support, such as helping the patient to re-orientate, close monitoring of vital signs and adequate hydration, and symptomatic treatment for agitation, autonomic instability, and hallucinations. In symptomatic treatment of DT, benzodiazepines are most commonly preferred due to their GABA-ergic effects. Diazepam, a benzodiazepine, has a faster onset of action than other benzodiazepines when administered intravenously (iv) and effectively controls symptoms. Although low doses of diazepam usually relieve DT symptoms, very high doses may be required in some patients. This case series discusses patients receiving high doses of diazepam to relieve DT symptoms.Case reportFour male patients aged from 43 to 57 years who regularly consumed alcohol with a daily average of 20-100 standard drinks and developed DT afterwards and were followed up in the intensive care unit are presented. In these patients, the symptoms of DT were relieved, and somnolence was achieved with the administration of very high-dose IV diazepam (260-480 mg/day), contrary to routine treatment doses. All patients were successfully treated and discharged without any morbidity.ConclusionSevere AWS can potentially result in death otherwise managed quickly and adequately. Diazepam is a suitable agent for severe AWS or DT treatment. Clinicians should keep in mind that high-dose diazepam treatment may be required in the treatment of DT that develops after a long-term and high amount of alcohol consumption. Publications reporting the need for very high doses of diazepam in DT are limited and usually published long ago; in this context, our findings are significant. The evidence is often based on case reports and uncontrolled studies, so controlled trials are needed to determine optimal treatment doses in severe DT.Öğe The Mental Health Status of Inpatients with Newly Diagnosed Hematological Cancer during the COVID-19 Pandemic: A Comparison Study(Gazi Üniversitesi, 2023) Korkmaz, Şükrü Alperen; Güney, Tekin; Akıncı, Sema; Çolak, Burgin; Can, FerdaObjective: This study is intended to evaluate the mental health statuses of hematological cancer (HC) inpatients diagnosed during the COVID-19 pandemic compared to the statuses of patients diagnosed with HC before the pandemic. Methods: A cross-sectional survey collected the mental health measurements of 77 inpatients with HC between March and May 2021 in Ankara, Turkey. The levels of depression, generalized anxiety, distress, sleep disorder, health anxiety, trait anxiety, corona phobia, and resilience in HC patients newly diagnosed during the pandemic (n=38) and before the pandemic (n=39) were compared. We then explored the relationships between predictive factors and cancer patients' mental health statuses. Results: Compared to HC patients diagnosed before the pandemic, depression (63.2% vs. 35.9%, p=0.017) and sleep disorder (67.8% vs. 38.5, p=0.016) were significantly higher, while comparison, generalized anxiety (57.9% vs. 38.5%, p=0.088) and distress (60.5% vs. 38.5%, p=0.053) were higher in a non-significant trend in patients newly diagnosed with HC during the pandemic. In contrast, health anxiety was more common in patients diagnosed before the pandemic (53.8% vs. 31.6%, p=0.048). Among the newly diagnosed patients, women had more generalized anxiety symptoms than men (76.5% vs. 42.9%, p=0.037). Being newly diagnosed increased the risk of more severe symptoms of depression (odds ratio [OR]: 3.178, p=0.036) and sleep disorders (OR: 4.73, p=0.018) but lowered the risk of health anxiety (OR: 0.14, p=0.003). Conclusion: Our data indicate that patients with HC are vulnerable to mental health problems during the COVID-19 pandemic. This vulnerability is higher in newly diagnosed HC patients than in patients diagnosed before the pandemic.Öğe Thiol-disulphide Homeostasis in Patients with Schizophrenia: The Potential Biomarkers of Oxidative Stress in Acute Exacerbation of Schizophrenia(Korean College of Neuropsychopharmacology, 2024) Korkmaz, Şükrü Alperen; Ulusoy Kaymak, Semra; Neşelioğlu, Salim; Erel, ÖzcanObjective: : Recent evidence suggests that oxidative stress contributes to the pathophysiology of schizophrenia. This study aimed to compare thiol-disulphide homeostasis in acute and stable phases of schizophrenia for the first time. Methods: : Among the patients with schizophrenia, 61 in the acute-phase and 61 in the stable phase of their illness were enrolled in the study. Native thiol (NT), total thiol (TT), disulphide (SS), disulphide/native thiol, disulphide/total thiol, and native thiol/total thiol for thiol-disulphide homeostasis were compared between the groups. The Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Positive/Negative Symptoms (SAPS/SANS), Clinical Global Impression-Severity Scale (CGI-S), Barnes Akathisia Rating Scale, and Simpson-Angus Scale were used to assess symptoms. Results: : After controlling for age, sex, body mass index, and smoking status there were significant differences in NT, TT, SS/NT, SS/TT, and NT/TT, but not SS. Thiol/disulphide homeostasis has shifted in favour of the oxidative side in patients with acute-phase compared to that in stable schizophrenia. BPRS, SAPS, and CGI-S scores were significantly correlated with all six thiol-disulphide parameters, but not SANS, when controlling for age and sex. Significant receiver operating characteristic (ROC) curves were obtained for all thiol-disulphide homeostasis parameters. Discriminant analysis was found to be statistically significant in discriminating between groups. Conclusion: : These results show that oxidative status increases thiol-disulphide homeostasis in patients with acute-phase schizophrenia compared to those with stable schizophrenia. These findings suggest that thiol-disulphide parameters can be used as biomarkers for the acute exacerbation of schizophrenia.
