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Öğe A Case of Psychogenic Movement Disorders: Dark Side of Neurology and Neuropsychiatry(Turkish Neuropsychiatry Assoc-Turk Noropsikiyatri Dernegi, 2012) Degirmenci, Yildiz; Oyekcin, Demet Gulec; Karaman, Handan Isin OzisikOur aim was to describe a patient with psychogenic movement disorder (PMD) who presented with tremor dominant involuntary movements, as well as to emphasize the clinical features important for establishing a correct diagnosis. A 48-year-old man presented to our outpatient neurology clinic with gait and speech disturbance. He had jerky, tremor-like involuntary movements occurring during gait, voluntary movements and/or at rest. The involuntary movements of the patient, who benefited from risperidone treatment and supportive interviews, substantially disappeared. Since PMDs are complex disorders, a multidisciplinary approach with cooperation of neurologistand psychiatrist is needed for proper diagnoses and treatment. (Archives of Neuropsychiatry 2012; 49: 235-237)Öğe Aripiprazole treatment and one year follow up of an interictal psychosis patient(Kure Iletisim Grubu A S, 2011) Oyekcin, Demet Gulec; Yildiz, DenizAripiprazole treatment and one year follow up of an interictal psychosis patient Objective: The presence of chronic neurological functional deficits in epilepsy increases susceptibility to psychiatric diseases. Especially, complex partial seizures are associated with psychiatric symptoms commonly and as many as %10-30 of patients may have psychosis. The classification has been made according to the time interval of the psychotic symptoms; ictal psychosis psychotic symptoms occur only during a seizure; postictal psychosis occurs after a short period, and seizures arising from persistent psychotic symptoms of schizophrenia-like condition are referred as interictal psychosis. Methods: A 42 year old patient with epilepsy since age 7, who had psychotic symptoms, was differentiated from schizophrenia and diagnosed with interictal psychosis based on the clinical features (ICD-10 schizophrenia like psychosis). He was treated with aripiprazole and his treatment response and 1 year follow up were discussed. An epileptic focus was determined in the right hemisphere on EEG and in left parietal lobe on PET and also left mesial temporal sclerosis (MTS) was detected on MRI. Aripiprazole 10mg/day, which is known to reduce the seizure threshold and also lower and improve the negative symptoms, was started. Treatment response was assessed by SANS, SAPS, and social- occupational functioning assessment questionnaires. First evaluations were conducted in the second week and there were dramatic changes in the scale scores. She also had significant clinical improvement especially in negative symptoms and social functioning. She was called to assess response to treatment second time after 4 weeks. Conclusion: Our case has the following features: We have offered a 1-year follow-up period and reviewed the similarities and the differential diagnosis from schizophrenia and the clinical symptoms observed in follow up of patients with interictal psychosis. Finally, our case also has a unique feature due to treatment of schizophrenia-like psychosis of epilepsy with aripiprazole. The antipsychotic treatments are known to reduce the threshold for epileptic seizures. However psychosis associated with epilepsy needs two-way thinking. Therefore we thought the so-called third-generation antipsychotic aripiprazole might be a good option to use. The clinical similarities and differences between idiopathic schizophrenia and schizophrenia-like psychosis of epilepsy are important to know for differential diagnosis and treatment planning.Öğe Chronotype and temperament relationship and the effect of chronotype on suicide risk in patients with unipolar depression(Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2019) Kilic, Neslihan; Oyekcin, Demet Gulec; Akinci, ErhanObjective: The aim of this study was to investigate the relationship between chronotype and temperament in patients with unipolar depression and the effect of chronotype on suicide risk. Methods: The participants consisted of patients with unipolar depression who were eligible for inclusion and exclusion criteria. Subjects were interviewed with the Structured Clinical Interview for DSM-5 and HAM-D, HAM-A scales. Patients filled the Morningness-Eveningness Questionnaire (MEQ), the Pittsburgh Sleep Quality Index, the Suicide Probability Scale and the Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire. Results: The participants were admitted female (n = 69) and male (n = 19). The rate of past suicide attempts was 24.1%. 50% of the patients had moderate depression and 50% of them had mild depression. According to MEQ scores patients were classified into three groups: 30.7% of them were eveningness, 58% of them were neither (intermediate) and 11.4 % of them were morningness type. The 90.8% of the patients had poor sleep quality. Depressive temperament was the most common temperament in the participants. Chronotype preference was not found to be associated with depression severity, anxiety, suicide probability, sleep quality and temperament characteristics. Discussion: There was not an association between temperament and chronotype preferences. Chonotype preferences do not affect the severity of depression. Chronotype is not a risk factor for suicide. In assessing the risk of suicide in patients with mild to moderate severity depression without comorbid psychiatric disorders; the clinical characteristics of depression should be prioritized by the clinicians, rather than temperament and chronotype.Öğe Cognitive Functions in Patients with Obsessive Compulsive Disorder(Turkiye Sinir Ve Ruh Sagligi Dernegi, 2013) Aydin, Pinar Cetinay; Oyekcin, Demet GulecAim: This literature review aimed to examine the relationship between cognitive impairment and obsessive-compulsive disorder (OCD). Studies based on neuropsychological testing were prioritized, but those dealing with clinical features, therapy, comorbidity, neuroimaging, and the families of OCD patients were also considered. Materials and Methods: The literature on cognitive impairment in OCD was reviewed and then the studies evaluating the relationship with these above mentioned findings were discussed. Results: The clinically most important cognitive impairment in OCD is executive dysfunction, followed by impaired memory. Cognitive impairment has also been observed in the healthy relatives of OCD patients. Findings regarding the effects of comorbidity on cognitive function in OCD patients are inconsistent. Brain imaging studies suggest that frontostriatothalamic dysfunction might occur in OCD. Conclusion: Executive dysfunction in OCD patients is well documented; however, the precise nature of the relationship between the severity of cognitive dysfunction and the clinical features of OCD are not well understood. Longitudinal family studies that employ both neuropsychological testing and brain imaging are needed to more clearly elucidate the relationship between cognitive dysfunction and OCD.Öğe Depression and Anxiety in Obese Patients(Aves, 2011) Oyekcin, Demet Gulec; Yildiz, Deniz; Şahin, Erkan Melih; Gur, SavasObjectives: Epidemiologic data suggests an association between obesity and depression. However, a limited number of studies have investigated the prevalence of psychiatric symptoms among obese patients without a psychiatric diagnosis. The objective of this study was to determine psychiatric diagnosis in patients with obesity who applied to the endocrinology department and to determine the pattern of the depression and anxiety symptom levels in obese patients without a psychiatric diagnosis. Materials and Methods: 62 patients with obesity (obesity group) and 27 control subjects (control group) attending the endocrinology outpatient clinic were included in the study. Body mass index was calculated and diagnostic psychiatric assessment carried out for all patients. All participants were evaluated using the Hamilton Depression Rating Scale [HAM-D] and Hamilton Anxiety Rating Scale [HAM-A]. Results: Total scores obtained both from HAM-D and HAM-A were significantly greater in the obesity group than in the control group. The most common psychiatric diagnose among obese patients was depression. Nearly more than half of the obese patients without any psychiatric diagnosis marked one of the HAM-D items which describes depressed mood, guilt feeling, somatic anxiety, work and activity loss and general somatic symptoms as well as the items within the HAM-A scale which describes anxious mood, tension, cognitive difficulties, insomnia, depressed mood, somatic anxiety, cardiovascular, respiratory, gastrointestinal and autonomic symptoms. Conclusion: Most common psychiatric diagnosis in patients with obesity was major depressive disorder. Obese patients who have not been diagnosed with any psychiatric disorder also show certain anxiety and depressive symptoms. The presence of anxiety and depressive symptoms in patients having any psychiatric disorder may be due to the psychosocial effects of obesity and these symptoms should be followed up in obese patients so that psychiatric disorders can be determined earlier.Öğe DEPRESSION, ANXIETY, BODY IMAGE, SEXUAL FUNCTIONING, AND DYADIC ADJUSTMENT ASSOCIATED WITH DIALYSIS TYPE IN CHRONIC RENAL FAILURE(Sage Publications Inc, 2012) Oyekcin, Demet Gulec; Gulpek, Demet; Şahin, Erkan Melih; Mete, LeventObjective: Depression is the most widely studied complication in dialysis patients. In patients with chronic renal failure, changes in body image are considered to be associated with invasive treatment interventions. In addition, sexual problems are common in dialysis patients. In this study, hemodialysis and peritoneal dialysis patients are investigated for depression, anxiety, body image, sexual satisfaction, and dyadic adjustment. Methods: Hemodialysis patients (n = 36), peritoneal dialysis patients (n = 54), and healthy controls (a = 30) were included in the study. All the subjects were assessed with Structured Clinical Interview for DSM-IV, Body Image Scale, Beck Depression Inventory, Beck Anxiety Scale, Golombok-Rust Inventory for Sexual Satisfaction, and Dyadic Adjustment Scale. Results: Depression (20.64 +/- 15.20) and anxiety levels (14.72 +/- 12.36) were significantly higher in hemodialysis group compared to peritoneal dialysis (13.54 +/- 12.51; 12.74 +/- 11.21) and control groups (7.17 +/- 5.58; 9.86 +/- 9.19). In peritoneal dialysis group, as depression and anxiety levels increased, body image was disturbed and sexual satisfaction decreased. In peritoneal dialysis group, body image (86.98 +/- 23.63) was better than hemodialysis group (101.58 +/- 26.51) and was not different from the control group (83.67 +/- 22.11). In hemodialysis group, as depression and anxiety levels increased, body image was disturbed. In both groups, long-term dialysis disturbed body image. Conclusion: Patients should be informed about the impacts of dialysis. Clinicians may wish to monitor dialysis-users for anxiety, depression, dyadic adjustment, and body image difficulties at follow-up appointments. Interventions that target intimate partner interventions, appearance-related beliefs, and anxiety depression may be of benefit to this population. (Int'l. J. Psychiatry in Medicine 2012;43:227-241)Öğe Effects of Sleep Hygiene Education on Subjective Sleep Quality and Academic Performance(Derman Medical Publ, 2016) Şahin, Erkan Melih; Ozturk, Levent; Oyekcin, Demet Gulec; Uludag, AysegulAim: Sleep problems are common in students with one third of university students reporting insufficient sleep. It is known that sleep quality and daytime sleepiness cause decrasing academic performans. For this reason we aimed to investigate the effects of a sleep hygiene education on sleep quality and academic performance of first year medical students. Material and Method: Self-reported sleep data and academic performance of 131 first grade medical students were collected. To all students enrolled Pittsburg Sleep Quality Scale in the assessment of sleep quality and Epworth Sleepiness Scale for assessment of daytime sleepiness in the evaluation. The students were divided into two subgroups and the intervention group received a 30 minute structured sleep hygiene education. Global academic performance was assessed by grade point average at the end of the year. Results: Mean Pittsburgh sleep quality index score of the students was 7.9 +/- 3.5 and 106 (82.8%) of then had a score >= 5. After intervention,. the worse the initial sleep quality, the more improvement by the sleep hygiene education on sleep quality and academic performance. Discussion: An education on sleep hygiene might improve subjective sleep quality and academic performance of medical students.Öğe Evaluation of the clinical characteristic of psychiatric patients who are among the risk groups in the COVID-19 pandemic(Bayrakol Medical Publisher, 2022) Mutlu, Pinar; Oyekcin, Demet Gulec; Mirici, Arzu; Gonlugur, UgurAim: The pandemic caused by COVID-19 has been a major concern for public health worldwide. Traditional medical practices need to be adapted quickly to meet the needs of vulnerable patients due to the COVID-19 outbreak. One of these patient groups is the mentally ill. Although COVID-19 itself affects mental health, this study aimed to investigate the clinical characteristics of COVID-19 patients who were previously diagnosed with mental illness. Material and Methods: Patients older than 18 years of age with COVID-19 pneumonia, PCR positive or negative, thoradc CT compatible with COVID-19 pneumonia, and who also had been diagnosed with psychiatric disease between 1 April - 1 October 2020 were included in the study Psychiatric diagnoses of the patients, drugs they used, places they lived, PCR results, CT results, comorbidities, the treatment of COVID-19, and the final status of the patients were evaluated. Results: Between the specified dates, the number of patients with COVID-19 with psychiatric disease was 37 (28.24%) out of 131. The average age of patients with COVID-19 was 56.63 +/- 11.25 years, and the average length of stay in the hospital was 5.57 +/- 1.52 days. There were 35 (94.6%) patients living in a nursing home. There were 26 patients (70.3%) with a previous history of psychiatric illness, and 23 of them (62.2%) had psychotic disorders. During the treatment period, 27 (73.0%) of the patients received multiple pharmacotherapies, and atypical antipsychotic drugs (51.4%) were mostly prescribed. Discussion: As a result, in our study, we determined that living in nursing homes, having a psychiatric disorder, and taking multiple pharmacotherapies due to this psychiatric disorder increase the possibility of getting COVID-19.Öğe Executive functions and memory in autogenous and reactive subtype of obsessive-compulsive disorder patients(W B Saunders Co-Elsevier Inc, 2014) Aydin, Pinar Cetinay; Koybasi, Gulperi Putgul; Sert, Engin; Mete, Levent; Oyekcin, Demet GulecThere are concurrently with different results of studies about cognitive functions of Obsessive-Compulsive Disorder (OCD), impairment in non-verbal memory and executive functioning in OCD, has shown consistent results in several studies. In this study, 62 OCD patients and 40 healthy controls were participated. Firstly, cognitive functions of OCD group and healthy control group were compared in terms of scores in Stroop Test, Wisconsin Cart Sorting Test (WCST), Auditory Consonant Trigram Test (ACTT), Controlled Word Association Test (CWAT), Rey Auditory Verbal Learning Test (RAVLT), Digit Span Test (DST). And then, two patient groups of OCD patients (patients with autogenous obsessions and patients with reactive obsessions) were compared in terms of the scores of same tests, with a hypothesis that claims, cognitive functions of patients with autogenous obsessions, who shown schizotypal personality features and thought disorder in higher ratio, will show more impairment than cognitive functions of patients with reactive obsessions. Significant impairment was found in OCD patients in terms of Stroop test and WCST scores when compared to scores of healthy controls. There was no difference pointed out between cognitive functions of patients with autogenous obsessions and reactive obsessions. Due to limited number of patients with autogenous obsessions in current study, any future research with greater sample size will be helpful to explain the cognitive functions in OCD with autogenous and reactive obsessions. (C) 2014 Elsevier Inc. All rights reserved.Öğe Mental health, suicidality and hopelessness among university students in Turkey(Elsevier Science Bv, 2017) Oyekcin, Demet Gulec; Şahin, Erkan Melih; Aldemir, EbruPsychological symptoms of university students can affect perceptions of physical and mental health and can influence the emergence of suicidal behavior. We investigated the association among psychological symptoms, suicidal thoughts, perceptions of physical and mental health in university students. 4330 students at Onsekiz Mart University completed an internet-based questionnaire. 15.1% of the students reported suicidal thoughts at least once in their lifetime. The severity of mental symptoms was found to increase with a decrease in perceived physical and mental health. 28.2% of the students had depression, 33.1% had anxiety. This research aims to contribute to the extensive body of work done regarding the mental health, suicidal thoughts and hopelessness among university students.Öğe Pharmacotherapy of Personality Disorders(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2012) Oyekcin, Demet Gulec; Yildiz, DenizObjective: Prevalence of personality disorders have been reported as 10-13% in general population, 30-50% in psychiatric patients, and 15% in psychiatric outpatients. The most common personality disorders are respectively borderline, antisocial, schizotypal, and avoidant. There has been no specific pharmacological approach for the treatment of personality disorders that have different clinical features with various co-morbid psychiatric disorders. The aim of this report is to review the efficacy of psychotropic medications used for the treatment of personality disorders. Methods: By using borderline, antisocial, schizotypal, narcissistic, obsessive compulsive, avoidant personality, and pharmacotherapy as keywords at the Pubmed database we primarily searched for the double blind, placebo controlled, randomized trials and also included some of the open label trials. Results: Most of the research on this topic was on pharmacotherapy of borderline personality disorder. Polypharmacy, that has been used widely in treatment of these cases, has been reported ineffective in most of the patients. The antidepressants have been replaced by mood stabilizers. The antidepressants and mood stabilizers have been reported to decrease mood symptoms like anger, depression, dysphoria, and to enhance adherence to psychotherapy. The most effective mood stabilizer was divalproex. The antipsychotics have been recommended to be used at psychotic and behavioral symptomatology. At the treatment of antisocial personality disorder CBT is recommended and there was no evidence based pharmacotherapy. In the treatment of schizotypal personality disorder, the antipsychotics have been reported effective. Pergolide and guanfacine have been reported to be useful in the treatment of cognitive disorders. The first line treatment options of avoidant personality disorder are venlafaxine and SSRIs. Conclusions: Most of the studies in literature have been focused at borderline personality disorder that has been difficult to treat. According to the guidelines, psychotherapy is the first line treatment for personality disorders. Pharmacotherapy has been reported to increase the efficiency of psychotherapy in BPD which presents with various symptoms of mood, cognition, and behavior. The studies in the literature report that Polypharmacy is not useful for these patients contrary to the popular belief. The research about other personality disorders is limited. More clear understanding of etiopathogenesis of personality disorders; would be helpful in development of more effective pharmacological agents in their treatment.Öğe Psychiatric co-morbidity and attachment styles in obese adults: A comparative study with healthy volunteers(Klinik Psikiyatri Dergisi, 2018) Oyekcin, Demet Gulec; Şahin, Erkan Melih; Aldemir, EbruObjective: Psychiatric co-morbidity and attachment issues are prevalent in obese patients. A possible relationship between insecure attachment styles and eating disorder risk has been proposed. The aim of this study is to determine the psychiatric co-morbidity, attachment styles and related risk factors in obese patients. Method: Obese patients with body mass index of 30 kg/m(2) or higher and non-obese controls matched for age, sex and education were included with a total sample of 173 participants. Diagnostic assessment using Structured Clinical Interview for DSM-IV Axis I Disorders and the Adult Attachment Scale, Hamilton Depression and Hamilton Anxiety scales were carried out. Attachment styles were classified as-anxious/ambivalent, avoidant and secure. The anxious/ambivalant and avoidant groups were combined and compared with the secure group. Results: Fifty three (40.8%) obese patients had psychiatric disorders including major depression (n=44; 33.8%). Anxiety was found to be a risk factor with obesity and BMI in both patients with or without any psychiatric co-morbidity. Psychiatric co-morbidity was significantly higher in obese patients (40.8%) than controls (18.6%). 55.4% of the participants had insecure attachment styles, it was significantly higher in obese patients. Insecure attachment styles were higher with psychiatric co-morbidity. Discussion: Psychiatric co-morbidity and insecure attachment styles were prevalent in obese patients, and the symptom of anxiety was found to be a predictor of obesity and body mass index. Psychiatric examinations including attachment styles and anxiety will help to advance better treatment strategies for obese patients.Öğe Psychosocial factors affecting various types of intimate partner violence against women(Turkiye Sinir Ve Ruh Sagligi Dernegi, 2012) Oyekcin, Demet Gulec; Yetim, Dilek; Şahin, Erkan MelihPsychosocial factors affecting various types of intimate partner violence against women Objective: Intimate partner violence against women is a growing global public health problem that is related to various psychosocial, cultural, mental, and economic factors. In this study, psychosocial factors affecting various types of intimate partner violence against women were investigated based upon affected individuals' statements. Methods: Demographic data, exposure to various types of partner violence, individual habits, partner habits, family functioning, and social support were inquired about during face to face interviews with 306 women chosen by stratified sampling to represent adult women living in Edirne, Turkey. Results: Among the participants, 54.5% were exposed to psychological violence, 30.4% were exposed to physical violence, 19.3% were exposed to economic violence, and 6.3% were exposed to sexual violence. Partner's age and the duration of marriage had a protective effect on intimate partner violence while worsening of marital relations, marriage by family decision, marriage against family consent, and the presence of a violent history against women in a partner's family had incremental effects on intimate partner violence. The duration of marriage, the worsening of marital relations and a history of violent exposure during childhood increased physical violence. Additionally, a decreasing family income, increasing economic violence, worsening of marital relations, and a decreasing social support network increased sexual violence against women. Conclusions: Recognizing and defining the effecting factors of intimate partner violence will aid in the understanding of the sources that generate and feed the violent behavior. Risk factors of different types of intimate partner violence vary. Our results indicate that any kind of violent behavior increases intimate partner violence against women.Öğe Seroprevalence of anti-Toxoplasma gondii and anti-Borrelia species antibodies in patients with schizophrenia: a case-control study from western Turkey(Taylor & Francis Ltd, 2015) Cevizci, Sibel; Celik, Merve; Alper Akçalı; Oyekcin, Demet Gulec; Sahin, Ozlem Ozturk; Bakar, CoskunObjectives. We examined IgG antibody seroprevalence and risk factors for anti-Toxoplasma gondii and anti-Borrelia sp. in schizophrenic patients. Methods. This case-control study included 30 schizophrenic patients and 60 healthy individuals. Serological analyses were identified by using ELISA technique. Results. In the case group the Toxoplasma seropositivity was 33.3% and Borrelia seropositivity was 13.3%, while in the control group the Toxoplasma positivity was 21.7% and Borrelia seropositivity was 15.0%. There was no significant difference with regard to seroprevalence between the groups (P = 0.232; P = 0.832, respectively). There was statistically significant difference between case and control groups related to hand and kitchen utensil hygiene after dealing with raw meat (P = 0.001). Conclusions. Our data showed the rate of Toxoplasma antibodies was higher in the case group, while the rate of Borrelia antibodies was higher in the control group. In both groups the high rates of seropositivity for Toxoplasma gondii and Borrelia sp. is thought to be due to neglect of personal hygiene. The present study also is the first to examine the association between Borrelia sp. and schizophrenia. Further studies are needed to determine whether there is an association between Borrelia sp. and schizophrenia or not.Öğe SUICIDAL IDEATIONS AND ATTEMPTS IN PATIENTS ADMITTED TO PSYCHIATRY OUTPATIENT CLINIC(Nobel Ilac, 2013) Oyekcin, Demet Gulec; Şahin, Erkan MelihObjective: The present study was conducted to determine the frequency of lifetime suicide attempts and suicidal ideations and to determine related risk factors on patients admitted to psychiatry outpatient clinic of Erzincan State Hospital. Material and Method: All the patients were asked for their suicidal ideations and behaviors in their lifetime. The sociodemographic data, number of application to outpatient clinics, the presence of a psychiatric disorder and a history of a suicide attempt within the family were questioned and recorded. The diagnosis based on DSM-IV-TR was determined after the psychiatric interview by the same psychiatrist. Among 1378 invited, 1073 participate in the study (77.9%). Results: Suicidal ideations were 28.3% (n=303) and attempts were 18.5% (n=198) during lifetime. Rate of suicidal attempts was 65.3% (198/303). Patients who considered or attempted suicide were more common among women than men. The most frequently diagnosed psychiatric condition was mood disorders followed by anxiety disorders for the patients with suicidal ideations and suicide attempts. For the group with suicidal attempts, the third most frequent diagnosis was somatoform disorders. Undiagnosed cases ranked third for the group with suicidal ideations. Conclusion: It is crucial to examine suicidal ideations and suicide attempts in all psychiatric patients. Following mood and anxiety disorders, the third most common diagnosis was somatoform disorders in patients living in rural areas of Eastern Turkey Suicide attempts may be used as a non-verbal language as part of somatization.Öğe The Child Who Pulls His Little Brothers' Hair: A Different Trichotillomania Case(Kare Publ, 2012) Oyekcin, Demet Gulec; Şahin, Erkan Melih; Demet, Mehmet MuratThe child who pulls his little brothers' hair: a different trichotillomania case Trichotillomania (TTM) is a relatively common cause of childhood alopecia. We report our observations of 8 year old boy referred for consultation for a 4 year history of hair pulling, nail-biting, nose picking, nail picking and scalp-picking. The most commonly affected sites on the scalp were frontal region and vertex. He had started pulling his hair when he was an infant and had a very chronic, unremitting course. During the last two years, he began to pull his two little brothers' hair when they were playing together or when they were sleeping. Both of his both brothers had alopecia on their scalp. It was discovered that there were frequent arguments, violence and negative behaviors at home. Few cases are reported in the literature about children who pull their siblings' hair. We considered that impaired affective interpersonal communication between mother and child, physical and emotional neglect and childhood trauma might have played a role in the development of TTM for this case. In childhood trichotillomania cases, it is important to investigate whether the siblings have hair loss.
