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    Comparison of the Emotion Regulation and Temperament Characteristics Between Depressive Patients With and Without Mixed Features
    (Turkish Neuropsychiatry Assoc-Turk Noropsikiyatri Dernegi, 2020) Tas, Halil Ibrahim; Altinbas, Kursat
    Introduction: Depressive disorder with mixed features has been included in the official classification in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Hypothesizing that difficulties in emotion regulation and affective temperament scores are higher in mixed depression comparing to pure depression, we aimed to evaluate the relationship between these phenomena and mixed symptoms. Methods: Depressive patients diagnosed by a psychiatrist according to the DSM-5 and had not received any psychiatric treatment for the last 3 months, were included in the study. The Hamilton Rating Scale (HDRS), modified Hypomania Checklist (mHCL), Difficulties in Emotion Regulation Scale (DERS), and the TEMPS-A (Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionaire) were applied to all participants. Results: Of the 63 participants, 40 (63.5%) were women. The mean age was 37.8 +/- 12.4 years while mean duration of education was 10.8 +/- 4.3 years. The proportion of mixed-depression assessed by the mHCL was 23.8% (n=15). No significant difference was found between the groups concerning gender, age, family history, age at onset of illness, the total number of episodes and temperament scores. Depressive patients with mixed features had significantly higher DERS nonacceptance subscale scores. Multiple regression analysis demonstrated that the cyclothymic temperament scale scores significantly affected the total mHCL scores. Conclusion: In mixed depression group, higher scores in nonacceptance subscale seems to reflect a tendency to fluctuations in the emotional reactions of a person to the stress. Association between mixed depression, DERS nonacceptance subscale and cyclothymic temperament support the spectrum view that mixed depression is placed between pure depression and bipolarity.
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    Evaluation of Four-Year Stability of Unspecified Psychosis
    (Aves, 2019) Tas, Halil Ibrahim; Celik, Merve; Altinbas, Kursat
    Introduction: Unspecified psychosis, defined with the F29 code in the International Classification of Diseases (ICD) 10th version is commonly used if there is inadequate information to make the diagnosis of a specific psychotic disorder. There is a lack of data about the prevalence, incidence, diagnostic validity and stability of this diagnosis. Therefore, we aimed to evaluate the prevalence and diagnostic consistency of unspecified psychosis in the outpatient unit. Methods: Patients diagnosed with the ICD-10 F29 code at the first visit and interviewed at least three times between January 2012-2016 in the Psychiatry Outpatient Clinic were included (n= 138). Hospital records were reviewed retrospectively and data were analyzed with SPSS 19th version. Results: Mean duration of follow-up was 22.8 +/- 14.7 months. The diagnoses at the final follow-up were unspecified psychosis (43%), bipolar disorders (18%), schizophrenia (11%), major depression (7%), and anxiety disorders (4%). No significant difference was found between the follow-up diagnoses in terms of age, duration of follow-up, gender, educational status and marital status. Conclusion: The diagnostic stability of unspecified psychosis is low compared to other psychotic disorders. Follow-up studies with larger sample sizes are required to elucidate the the low diagnostic stability of unspecified psychosis.
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    Evaluation of oxidative stress with thiol disulfide balance parameters in unipolar depression patients with and without mixed symptoms
    (Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2020) Acar Yildizoglu, Ciler; Tas, Halil Ibrahim
    Objective: Number of studies evaluating oxidative stress in unipolar depression are increasing. The aim of this study was to evaluate the scores of oxidative stress in unipolar depression patients and in mixed type of unipolar depression and to compare these scores with healthy subjects in terms of dynamic thiol/disulfide balance parameters. Methods: Ninety-eight patients aged between 18 and 65 years with the diagnosis of unipolar depressive disorder diagnosed according to DSM-5 criteria and 97 age- and sex-matched 97 healthy individuals who applied to the Psychiatry Outpatient Clinic of Canakkale Onsekiz Mart University Faculty of Medicine Psychiatry Department between April 2018 and September 2018 were included in the study. Hamilton Depression Rating Scale (HAM-D) and Modified Hypomania Checklist (M-HCL) were used respectively to determine depressive symptoms, manic symptoms and the severity of the disease. Oxidative stress parameters were measured by evaluating fasting blood samples taken from all participants. Results: In the unipolar depression group, the levels of disulfide, total thiol, oxidation-reduction and oxidized thiol levels were found to be statistically significant in favor of oxidation (p<0.05). Reduced thiol levels, which are favorable for the antioxidant system, were statistically lower than the control group (p<0.05). There was no statistically significant difference between the mixed featured depression as a specifier for unipolar depression and non-mixed featured unipolar depression in thiol-disulfide balance. Discussion: The studies to be carried out longitudinally in terms of the oxidation balance, in which all depression specifiers are evaluated, will shed more light on this subject. In our study, dynamic thiol/disulfide balance parameters in favor of increased oxidation were shown to be significantly higher in the depression group than the control group. There was no significant difference between the dynamic thiol/disulfide balance parameters between the mixed depression group and the non-mixed depression group. This finding showed that the balance deteriorated in favor of oxidation in depression may not make a significant difference in terms of depression prognosis in mixed symptom depression. Longterm studies that assess all depression predictors in terms of oxidation balance will shed more light on this issue.
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    Evaluation of the diagnostic continuity of unspecified mood disorders
    (Yerkure Tanitim & Yayincilik Hizmetleri A S, 2019) Tas, Halil Ibrahim; Ozusta, Ozlem
    Objective: According to ICD-10, the diagnosis of unspecified mood disorder (UMD), coded 'F39,' is used when there is insufficient or contradictory information about the patient and the symptoms of mood disorder are not sufficient to diagnose a specific mood disorder. Information about the frequency, diagnostic validity and continuity of this diagnosis is unsatisfactory. Therefore, we aimed to evaluate the prevalence and diagnostic continuity of this diagnosis among individuals diagnosed with UMD in our outpatient clinic. Method: Included in the study were patients who presented to the psychiatry outpatient unit for the first time between January 2011 and December 2017, were diagnosed with mood disorder code 'F39' at the first admission, and presented at least three times in different periods (n=48). Outpatient unit records were evaluated retrospectively and the data were analyzed with SPSS version 19.0. Results: The mean follow-up period of 48 patients included in the study was 14.4 +/- 13.9 months. The final diagnoses of the patients after follow-up were UMD (42%), depressive disorder (25%), bipolar disorder (17%), and anxiety disorder (10%). It was found that the duration of the follow-up for individuals diagnosed with UMD was significantly shorter than for those with a different diagnosis. No significant difference was found between final diagnoses in terms of age, gender, level of education, and marital status. Conclusion: UMD has less diagnostic stability than other mood disorders. Therefore, longer follow-up durations are needed in patients with UMD, and it is crucial to reconsider the diagnosis during follow-up. Further studies with larger samples are needed to elucidate the stability of UMD.
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    Investigation of the Relationship between Inflammation and Oxidative Stress Markers and Treatment Response in First-Attack Major Depression Patients: A Follow-Up Study
    (Turkiye Sinir Ve Ruh Sagligi Dernegi, 2023) Emekdar, Gizem; Tas, Halil Ibrahim; Sehitoglu, Hilal
    Objective: There is a need to biomarkers for major depression (MD). The goals of this study are to compare serum levels of oxidative stress markers malondialdehyde (MDA) and F2-isoprostane and inflammation markers tumor necrosis factor-alpha (TNF-& alpha;), interleukin-6 (IL-6) and C-reactive protein (CRP) between patients with first-episode MD and healthy controls, to investigate the change of these markers after treatment and to investigate the relationship between levels of these markers and treatment response.Method: Our study was performed in 30 first-episode MD patients and 30 healthy volunteers. During the clinical evaluation Hamilton Depression Rating Scale and Clinical Global Impression Scale were applied to the participants. Serum levels of markers were measured at the baseline and after 8 weeks of treatment.Results: Compared to the control group, first-episode MD patients had significantly higher IL-6, CRP and MDA levels and lower F2-isoprostane levels. There was no difference between the groups in terms of TNF-& alpha; levels. TNF-& alpha;, IL-6, MDA and F2-isoprostane levels decreased significantly after treatment, whereas there was no significant change in CRP levels with treatment. Baseline F2-isoprostane levels were found to be significantly higher in treatment responders than non -responders (p<0.05).Conclusion: In our study, it was shown that there are irregularities related to inflammatory processes and oxidative stress in MD, even in patients who had their first-episode and did not take medication, and these irregularities can be resolved after treatment. While there was a relationship between treatment response and baseline F2-isoprostane levels, there was no relationship with other biomarkers.
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    Relationship between functional constipation and anal-retentive behavior features
    (Turkish Surgical Assoc, 2019) Yilmaz, Tonguc Utku; Tas, Halil Ibrahim; Ucar, Ezgi; Cerit, Cem; Celebi, Altay; Guler, Sertac Ata; Utkan, Zafer
    Objective: Constipation is the most commonly seen defecation problem related to several environmental factors. Defecation is learned in the childhood anal period in which anal characteristic features appear. Problems in the childhood anal period may affect not only characters but also defecation function. This study aimed to evaluate the relationship between constipation and anal characteristic features of participants with functional constipation. Material and Methods: Patients with functional constipation were included into the study according to the ROME III criteria. Patients with irritable bowel disease, slow transit constipation, outlet obstruction constipation, malignancy, and psychiatric diseases were excluded from the study. Patients filled out Personality Belief Questionnaire, Hospital Anxiety and Depression Scale, and Obsessive Belief Questionnaire. The results were compared with healthy individuals. Results: A total of 47 patients with functional constipation were included in the study. Avoidant, obsessive-compulsive, antisocial, narcissistic, and paranoid personality traits were found to be higher in patients with constipation than in the control group. Perfectionism/certainty, importance and control, and hospital anxiety scores were found to be higher in patients with constipation than in the control group. Conclusion: Constipation may be related to several factors, such as socioeconomic environment, emotional stress, age, and diet, among others. Here, it was found that anal-retentive behavior features are prominent in functional constipation. Biofeedback, which can be regarded as psychotherapy of defecation control, can be used for treatment.
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    The role of anxious temperament in patients with allergic rhinitis
    (Saudi Med J, 2019) Tas, Halil Ibrahim; Caglar, Ozge
    Objectives: To evaluate the depressive and anxiety levels in allergic rhinitis (AR) and to investigate the relationship between depression and anxiety symptoms and depressive and anxious temperament features. Methods: The study design is cross-sectional. The study was conducted between January 2017 and January 2018. Patients (n= 101) diagnosed with AR and healthy controls (n= 74) were included in this study. All participants were assessed with the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and TEMPS-A (Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionaire). Results: The median BAI and BDI scores of the patients were found to be significantly higher than the control group (p=0.016 and p=0.001). In AR patients, the percentage of depressive and anxious temperaments were significantly higher than in the control group (p=0.029). Depressive temperament scores showed strong positive correlation with anxious temperament and BDI scores and a medium relationship with the BAI (r; p=0.639; p< 0.001, p= 0.671; p< 0.001, and p= 0.495; p< 0.001, respectively). Participants with anxious temperament had 6.3-times (95% CI: 1.3-28.3) the risk for developing AR. Conclusion: Screening of temperament traits in AR patients may allow prediction of future depression and anxiety symptoms. These temperament traits may be mediators of depression and anxiety in AR patients. Depressive and anxious temperament traits may contribute to both depression and allergy.