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Background Despite the multiple alternatives of treatment, it is well known that patients with obsessive-compulsive disorder (OCD) delay seeking treatment. In this study, the aim was to determine the risk factors for delaying treatment seeking in OCD patients. Methods The sample consisted of 132 OCD who completed the Yale-Brown Obsessive-Compulsive Scale, Yale-Brown Obsessive-Compulsive Scale Symptom Checklist, and Beck Depression Inventory. Results In univariate analyses with risk evaluation, income level, being single or divorced, having a history of psychiatric treatment, poor insight for the symptoms, and obsessions of hoarding were the variables that were found to be significant. In the regression model, history of psychiatric treatment and duration of OCD were the 2 variables that remained statistically significant. Conclusion This was the first study wherein the sample included patients who were recruited from a nonpsychiatric department: the dermatology clinic. Application to dermatology has not been determined as a risk factor for delaying treatment seeking in OCD patients.

In this present work, it is aimed to demonstrate BDNF serum concentrations in patients with dysthymia and to compare them with BDNF serum concentrations in patients with major depressive disorder and healthy subjects. The study was carried out in Celal Bayar University Hospital, Manisa, Turkey. Seventeen patients with dysthymia, 24 patients with major depressive disorder and 26 subjects without any psychiatric diagnosis and any psychiatric treatment were included in the study. The severity of depression was assessed with 17-item HAM-D. All subjects were asked to give their written consent. Blood samples were collected at baseline. Serum BDNF was kept at − 70 °C before testing, and assayed with an ELISA Kit (Promega; Madison, WI, USA), after dilution with the Block and Sample solution provided with the kit. The data were subjected to the analysis of variance. The BDNF serum concentrations of the dysthymia group (mean = 28.9 ± 9.2 ng/ml) were significantly higher than that of the major depressive disorder group (21.2 ± 11.3 ng/ml) ( p = 0.002), and it was not different from the level of the control group (31.4 ± 8.8 ng/ml). BDNF serum concentrations and HAM-D score did not have any significant correlation in the dysthymia and major depression groups ( r = − 0.276, p = 0.086). The low level of BDNF in patients with dysthymic disorder seems to point out that BDNF changes in mood disorders are state-dependent and vary according to the severity of depressive episodes.

Although many studies have examined the neurobiological aspects of suicide, the molecular mechanisms and pathophysiologic mechanisms associated with suicide remain unclear. In this study, it is aimed to investigate whether there is a difference in serum brain-derived neurotrophic factor (BDNF) levels among suicide attempters without a major psychiatric disorder, compared to major depressive disorder patients and healthy subjects. It was undertaken with the hypothesis that suicide per se lowers serum BDNF levels, since it is a source of stress. The study was carried out in Celal Bayar University Hospital, Manisa, Turkey. Ten suicide attempters, 24 patients with major depressive disorder and 26 subjects without any psychiatric diagnosis and any psychiatric treatment were included in the study. All subjects were asked to give their written consent. Blood samples were collected at the baseline. Serum BDNF was kept at –70°C before testing, and assayed with an ELISA kit (Promega; Madison, Wisc., USA) after dilution with the block and sample solution provided with the kit. The data were subjected to the Kruskal-Wallis test for nonparametric analysis of variance. Mean serum BDNF levels were significantly lower in the suicide group (21.2 ± 12.4 ng/ml) and the major depressive disorder group (21.2 ± 11.3 ng/ml) than the control group (31.4 ± 8.8 ng/ml; p = 0.004). These results suggest that BDNF may play an important role in the neurobiology of suicidal behavior. BDNF levels may be a biological marker for suicidal behavior. To investigate the role of BDNF in suicide, further studies with a wider sample size and a variety of psychiatric diagnoses accompanying suicide attempt are needed.

Psoriasis can have a significant impact upon sexual function. The aim of this study was to investigate sexual function in females and males with psoriasis and to evaluate whether coexistent depression has an additional negative effect on sexual function in these patients. A total of 66 female subjects (39 with psoriasis and 27 healthy volunteers as a control group) and 70 male subjects (39 with psoriasis and 31 healthy volunteers as a control group) were enrolled in the study. A Psoriasis Area and Severity Index (PASI) was used to determine the severity of psoriasis for the patient groups. The Female Sexual Function Index (FSFI) was used to assess female sexual function and the International Index of Erectile Function (IIEF) was used to evaluate male sexual function. Quality of life was assessed with the Dermatology Life Quality Index (DLQI). The diagnosis of depression was made according to the Structured Clinical Interview for DSM-IV (SCID-I) interview and Hamilton Depression Rate Scale (HDRS) was used for grading depression. FSFI total score was found to be significantly decreased in female psoriatic patients without depression and psoriatic patients plus depression compared with healthy controls (24.09 +/- 5.33 vs. 24.25 +/- 4.52 vs. 28.12 +/- 3.48, respectively, p = 0.004). However, FSFI score was not significantly different between patients with psoriasis without depression and those with psoriasis plus depression (p > 0.05). IIEF total score was also found to be significantly decreased in male psoriasis without depression and psoriasis plus depression patients compared with healthy controls (54.21 +/- 13.07 vs. 52.0 +/- 14.73 vs. 61.69 +/- 9.49, respectively, p = 0.023). The difference in IIEF scores between patients with psoriasis without depression and in those with psoriasis plus depression were not statistically significant (p > 0.05). The results of the study demonstrated that patients with psoriasis, especially females have distinct sexual dysfunction compared with healthy controls, and coexistent depression has no additional negative effect on sexual dysfunction in our patients. Patients with psoriasis should be evaluated in terms of sexual function in order to provide a better quality of life.

Objective The aims of present study were to (a) to determine the prevalence of obsessive–compulsive disorder (OCD) in dermatological patients, (b) to determine the possible relationship between dermatological lesions and OCD and (c) to determine the clinical and phenomenological features of the OCD subgroup. Method The sample consisted of 166 out of 250 consecutively presenting dermatological patients who agreed to participate in the study. The subjects were assessed with the Structured Clinical Interview for DSM-IV Turkish Version (SCID-I) and also completed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Results Of the whole sample, 41 (24.7%) met DSM-IV criteria for OCD. Only 14.6% of them had previously been diagnosed as OCD. The mean score of Y-BOCS in the OCD group was 17.05±9.75. The most common obsessions were contamination (61%) and pathologic doubt (53.7%), while washing (61%) and checking (51.2%) were the most frequent compulsions. Those suffering from diseases of sebaceous glands were the only group that showed a significant difference between the OCD and non-OCD group. Conclusion There is a high prevalence of OCD in dermatological patients, although the nature of the relationship between OCD and dermatology has not previously been ascertained. Genetic-based studies and future researches focused on individual anxiety, and sensitivity may provide information that better explains this relationship.

Recent studies suggested a role of brain-derived neurotrophic factor (BDNF) in depression. While BDNF levels are lower in depressed patients, antidepressant treatment increases serum BDNF levels of depressed patients. Our study aims to test the effect of chronic venlafaxine treatment on serum BDNF levels in patients with a major depressive disorder. Ten patients diagnosed as major depressive disorder according to DSM-IV are included in the study. Two of the patients had their first episode and were drug-naive, the other eight patients were drug-free for at least 4 weeks. The severity of depression was assessed with Hamilton Depression Rating Scale (HDRS). The control group consisted of ten age- and sex-matched subjects without any psychiatric disorder. Blood samples were collected at the baseline and after 12 weeks of antidepressant treatment (during remission). At the baseline the mean serum BDNF level was 17.9+/-9.1 ng/ml and the mean HDRS score was 23.2+/-4.6. Serum BDNF levels of the study group were significantly lower than in the control group (31.6+/-8.6 ng/ml). At the end of the study, the mean serum BDNF level was 34.6+/-7.1 ng/ml whereas the mean HDRS score was 8.2+/-3.9. From the baseline to the remission after 12 weeks of treatment, the increase in serum BDNF level and the decrease in HDRS score were statistically significant, respectively. When we compared the serum BDNF level of depressed patients at remission to that of the controls, there was no statistically significant difference. This study shows that venlafaxine treatment of depression improves serum BDNF level which may be considered as a nonspecific peripheral marker of depression.

WOS: 000363521400005 PubMed ID: 26245463 The purpose of this study was to investigate the relationship among Turkish primary health care workers' socio-demographic characteristics, working conditions, and anxiety. A cross-sectional study was conducted with 88 of 103 (85.4%) eligible health care workers from the city of Mugla participating. The participants' average age was 31 years, 85.2% were university graduates, 30.7% were nurses, and 64.8% had been working between 11 and 20 years at the time of the study; 93.6% worked 8 hours each day or less. State anxiety scores for males (p = .016), health care workers age 31 or older (p = .035), nurse participants (p = .043), and individuals who had worked 11 or more years (p = .044) were significantly higher than the rest of the sample; however, trait anxiety scores for participants who did not work overtime and were not scheduled for shift work were significantly higher (p = .033 and p = .004, respectively) than the rest of the sample. According to the logistic regression analysis, risk factors for anxiety included being male and older than 31 years.

Our objective was to determine symptomatology of depression and anxiety in patients with untreated hyperthyroidism and compare with euthyroid patients.Thirty-two patients with hyperthyroidism (high free T3 and free T4, and suppressed TSH) and 30 euthyroid (normal free T3, free T4, and TSH) controls attending the Endocrinology Out-Patient Department at Celal Bayar University Hospital in Manisa, Turkey were included in the study. Hormonal screening was performed by immunoassay and hemagglutination method. For psychiatric assessment, Hospital Anxiety and Depression Scale [HAD], Hamilton Depression Rating Scale [HAM-D], and Hamilton Anxiety Rating Scale [HAM-A] were used. There was no difference between the two groups in terms of demographic features.Total scores obtained both from HAM-D and HAM-A were significantly greater in the hyperthyroidism group than that of the euthyroid group (p0.05); there was no difference in terms of HAD. When compared in terms of symptomatology, early insomnia (HAM-D#6), work and activities (HAM-D#7), psychic anxiety (HAM-D#10), weight loss (HAM-D#16), insomnia (HAM-A#4), and cardiovascular symptoms (HAM-A#8) were significantly more frequent in the hyperthyroidism group. By Wilks lambda discriminant analysis, psychomotor agitation (HAM-D#9), weight loss (HAM-D#16), and insomnia (HAM-A#4) were found as the discriminating symptoms for the hyperthyroidism group, whereas somatic anxiety (HAM-A#11) and loss of interest (HAD#14) were distinguishing symptoms of the euthyroidism group.Hyperthyroidism and syndromal depression-anxiety have overlapping features that can cause misdiagnosis during acute phase. For differential diagnosis, one should follow-up patients with hyperthyroidism with specific hormonal treatment and evaluate persisting symptoms thereafter. In addition to specific symptoms of hyperthyroidism, psychomotor retardation, guilt, muscle pain, energy loss, and fatigue seem to appear more frequently in patients with comorbid depression and hyperthyroidism; thus, presence of these symptoms should be a warning sign to nonpsychiatric professionals for the need for psychiatric consultation.

Background In some periods of a woman's life the risk of depression increases and the postnatal period is one of these. The prevalence and the risk factors of postnatal depression are not systematically studied in Turkey. The aim of this study is to investigate the epidemiological aspects and the cultural factors that may affect postnatal depression in our country. Method According to the records of ten primary health care centres in Manisa, a city in western Turkey, there were 1,337 women who had given birth in the previous 6 months. A sample group of 317 mothers were randomised among these women and 257 (81.7 %) of the sample group could be reached. Data were collected by use of the Edinburgh Postnatal Depression Scale and a questionnaire on sociodemographic variables designed for this study. Results The mean depression score was found to be 7.54 ± 4.66. When the cut-off point was taken into consideration, 14 % of mothers had a syndromal depression. The factors which affected the prevalence of depression were the number of living children, living in a shanty, being an immigrant, serious health problems in the baby, previous psychiatric history, psychiatric disorder in the spouse, and having bad relations with the spouse and his parents. Conclusion These findings revealed that the prevalence of postnatal depression in the Manisa province and the factors affecting it were very similar to other studies; but the negative impact of bad relations of the mother with her family-in-law on postnatal depression seems to be a distinguishing aspect of Turkish culture.

Background: Brain-derived neurotrophic factor (BDNF) gene polymorphisms are associated with abnormalities in regulation of BDNF secretion. Studies also linked BDNF polymorphisms with changes in brainstem auditory-evoked response test results. Furthermore, BDNF levels are reduced in tinnitus, psychiatric disorders, depression, dysthymic disorder that may be associated with stress, conversion disorder, and suicide attempts due to crises of life. For this purpose, we investigated whether there is any role of BDNF changes in the pathophysiology of tinnitus. Materials and Methods: In this study, we examined the possible effects of BDNF variants in individuals diagnosed with tinnitus for more than 3 months. Fifty-two tinnitus subjects between the ages of 18 and 55, and 42 years healthy control subjects in the same age group, who were free of any otorhinolaryngology and systemic disease, were selected for examination. The intensity of tinnitus and depression was measured using the tinnitus handicap inventory, and the differential diagnosis of psychiatric diagnoses made using the Structured Clinical Interview for Fourth Edition of Mental Disorders. BDNF gene polymorphism was analyzed in the genomic deoxyribonucleic acid (DNA) samples extracted from the venous blood, and the serum levels of BDNF were measured. One-way analysis of variance and Chi-squared tests were applied. Results: Serum BDNF level was found lower in the tinnitus patients than controls, and it appeared that there is no correlation between BDNF gene polymorphism and tinnitus. Conclusions: This study suggests neurotrophic factors such as BDNF may have a role in tinnitus etiology. Future studies with larger sample size may be required to further confirm our results. © 2017 Noise & Health | Published by Wolters Kluwer - Medknow.

The aim of this study was to evaluate the level of depression in women of reproductive age (15-49 years) and to determine if there was a relationship between depression score, and socioeconomic variables and the presence of domestic violence.The study group included women aged 15-49 years that lived in the Manisa/Muradiye Health Center catchment area. The minimum sample size was calculated as 224 and multistage sampling was used (random sampling plus cluster sampling). In all, 225 women enrolled in the study and were administered the BDI and a sociodemographic questionnaire that collected depressive symptomatology, domestic violence, and sociodemographic data. In addition to the descriptive data, univariate and multivariate odds ratios were obtained. Logistic regression was used for multivariate analysis.The prevalence of depressive symptoms (BDI score≥17) was 14.7%. In all, 32.9% of the women had experienced domestic violence. Multivariate analysis revealed that the prevalence of depressive symptoms was significantly higher among the women that had experienced domestic violence and reported having a chronic illness (p0.05).The rates of depressive symptoms and domestic violence were quite high among the married women in this study. Preventive mental health programs should be developed and implemented in the study area.

Neurodermatitis is a chronic disease affecting the patient's psychosocial status and quality of life. It is associated with a variety of psychologic problems, including demoralization, depression, anxiety, obsessive-compulsive disorder, and sleep disturbances. Coexistence of sexual dysfunction, especially in women, with several systemic diseases has gained interest in recent years. In this study, we evaluated sexual function in female patients with neurodermatitis. We enrolled 89 women (43 patients, 46 controls) in the study. Quality of life was assessed with the Dermatology Life Quality Index (DLQI), and the Female Sexual Function Index (FSFI) was used to determine sexual function. Individuals with psychiatric disorders and/or those using antidepressants were excluded. The total DLQI score was 11.95 ± 5.65 in patients with neurodermatitis. The total FSFI score was significantly lower in patients compared with healthy controls (22.76 ± 5.31 and 28.83 ± 3.50, respectively; P = .001). Domain scores of FSFI (desire, arousal, lubrication, orgasm, and satisfaction) except pain were significantly lower in patients with neurodermatitis (P = .001). The pain score was also lower in patients than controls, but the difference was not statistically significant (P = .073). Neurodermatitis may be associated with sexual dysfunction, and patients with neurodermatitis should be evaluated with regard to sexual function to provide a better quality of life.

The aim of this study was to determine the effect of psychosocial skills training (PST) on symptomatology, insight, quality of life, and suicide probability in patients with schizophrenia.The sample consisted of 22 schizophrenic outpatients diagnosed according to DSM-IV diagnostic criteria. Three PST groups were formed and each group's training lasted approximately 6 months. Nineteen (86%) patients completed the study. The Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, Calgary Depression Rating Scale for Schizophrenia, Schedule for Assessing the Three Components of Insight, Quality of Life Scale for Patients with Schizophrenia, and Suicide Probability Scale were administered to the patients before and after PST.At the end of the study mean score for the Scale for the Assessment of Positive Symptoms score (baseline 8.5+/- +/- 9.9, post-PST 3.4 +/- +/-6.0, P = 0.004), Scale for the Assessment of Negative Symptoms (baseline 33.7 +/- +/-19.3, post-PST 22.1 +/- +/-15.7, P = 0.001), Calgary Depression Rating Scale for Schizophrenia (baseline 4.2 +/- +/-4.1, post-PST 0.7 +/- +/-1.0, P = 0.001), Schedule for Assessing the Three Components of Insight (baseline 11.1 +/- +/-3.4, post-PST 16.2 +/- +/-1.1, P0.0001), and Quality of Life Scale for Patients with Schizophrenia (baseline 53.5 +/- +/-20.0, post-PST 79.6 +/- +/-20.8, P0.0001) changed significantly, whereas the change in mean score for the Suicide Probability Scale (baseline 75.1+/- +/- 11.7, post-PST 71.3+/- +/- 8.0, P = 0.06) did not reach statistical significance.This study demonstrated the effects of PST on the symptoms and functioning of patients with schizophrenia. It can be concluded that using PST for the treatment of schizophrenia, as an adjuvant to pharmacotherapy, could produce significant positive results.

The aim of the present study was to compare serum brain-derived neurotrophic factor (BDNF) levels of patients with major depressive disorder (MDD) and conversion disorder (CD). Serum BDNF levels were measured in the following three groups: 15 CD patients without any comorbid diagnosis of psychiatric disorder, 24 patients with MDD, and 26 healthy subjects without any psychiatric diagnosis or psychiatric treatment. The serum BDNF level of the healthy control group (31.4 +/- 8.8 ng/mL) was statistically higher than the level of the MDD group (21.2 +/- 11.3 ng/mL) and the CD group (24.3 +/- 9.0 ng/mL; P = 0.008). This suggests that BDNF level may play a similar role in the pathophysiology of MDD and CD.

Hand eczema can cause considerable psychosocial disorders, such as anxiety, depression, and difficulties at work, and it may also cause sexual dysfunction.The aim of this study was to investigate sexual function in patients with hand eczema and to find out whether concomitant depression has an additional negative effect on sexual function in these patients.Sexual functions were evaluated in hand eczema patients.Ninety-one female (43 patients vs. 48 controls) and 79 male (45 patients vs. 34 controls) subjects were enrolled in the study. Hand eczema severity index was used to determine severity of hand eczema. The Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF) were used to assess sexual function. Quality of life was assessed with the Dermatology Life Quality Index. Diagnosis of depression was made based on the Structured Clinical Interview for the DSM-IV, while the Hamilton Depression Rate Scale was used for grading depression.Among 43 female subjects with hand eczema, 26 had depression (60.46%); of the 45 male patients, 11 had depression (24.44%). FSFI total score was found to be significantly decreased in female patients with both eczema and depression compared with controls (20.84 +/- 9.19 vs. 24.04 +/- 3.40, P0.05). FSFI total score was found to be significantly decreased in female patients with both eczema and depression compared with those without depression (20.84 +/- 9.19 vs. 22.23 +/- 5.82, P0.05). IIEF total score was also found to be significantly decreased in male patients with or without depression compared with controls (52.36 +/- 14.83 vs. 59.88 +/- 5.65 vs. 62.03 +/- 11.04, P0.05).The results of the study demonstrated that patients with hand eczema had sexual dysfunction, and concomitant depression had an additional negative effect on sexual dysfunction. Patients with hand eczema should be evaluated with regard to sexual function and depression to provide a better quality of life.

There is not a wide agreement upon rate of conversion disorder within Turkish population. The aim of this study was to determine the prevalence of conversion disorder with pseudoneurological symptoms or deficits and related risk factors in a city. In total, 1,086 people, aged 15–65 years old, were selected from the city of Manisa, Turkey to take part in the study. We applied sociodemographic and health information questionnaires and the Composite International Diagnostic Interview (CIDI) Somatization Subscales to the samples. The likelihood that an individual might have conversion disorder with pseudoneurological symptoms or deficits was found to be 5.6% (n = 61). The prevalence of conversion disorder with pseudoneurological symptoms or deficits was significantly higher among women (p

Suicide attempts are a major public health problem. This study aimed to investigate the lifetime prevalence of suicide ideation and suicide attempts in Manisa city centre. Risk factors related to suicide ideations and attempts were also studied.This study was carried out in Manisa city centre. Using cluster and systematic samples, data were collected from 1086 persons 15-65 years old. Separate questions were asked about the lifetime occurrence of suicide ideation (''Have you ever seriously thought about committing suicide?''), and suicide attempts (''Have you ever attempted suicide?''). A form for suicide attempters was used to determine the characteristics of the attempts.The lifetime prevalences of suicide ideation and suicide attempts were 6.6% (n=72) and 2.3% (n=25), respectively. Marital problems were the most common stressor in suicide attempts (44%, n=11). Approximately two thirds of the suicide attempters used a drug overdose for suicide. Of all the suicide attempters, 24% (n=6) had made previous attempts. The essential risk factors for suicide ideation were being female (p=0.012), smoking (p=0.001), consuming alcohol (p=0.028), having a previous psychiatric disorder (p0.0001), and a family history of psychiatric disorders (p=0.021). The essential risk factors for suicide attempts were smoking (p=0.005), having a previous psychiatric disorder (p0.0001), and a family history of psychiatric disorders (p=0.029).The results of the present study suggest that suicide attempts must be carefully evaluated in subjects with previous psychiatric disorders, previous suicide attempts and a family history of psychiatric disorders. It is necessary to know the clinical and demographic features related to suicide attempts.

Background: Pruritus is a common symptom of many dermatological and systemic diseases. It is a common complaint among patients with psoriasis of the chronic plaque type. Patients with pruritus suffer from more severe psoriasis although some authors did not find a significant relationship between pruritus intensity and psoriasis severity. Aims: In this study, we aimed to investigate the relationship between clinical features and symptoms among psoriasis patients. And also we aimed to evaluate whether the severity of disease, depression and quality of life scores could effect these symptoms or not. Methods: Eighty seven patients with psoriasis were enrolled in this study. Epidemiological data of patients were noted. Clinical symptoms, such as pruritus, pain, burning, exudation, bleeding, weakness, etc. were interrogated. The answers to these questions were classified as 'never', 'rare', 'sometimes', 'often' and 'all the time'. Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), Hamilton Anxiety-Depression Scale (HAD) were calculated for each patient. PASI and DLQI scores were classified as ≥ and