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Varenicline is an alpha 4 beta 2 nicotinic receptor partial agonist with dopaminergic effects. It is an effective and widely used agent approved for smoking cessation. Depressive mood, sleep disorder, suicide, agitation, aggression, psychotic and manic symptoms have been reported during the use of varenicline. We report the case of a 48-year-old woman with a history of major depression who was admitted to the hospital with the diagnosis of mania with psychotic features at the end of the 12-week varenicline treatment. She was admitted to the psychiatry clinic for mystic grandiose and reference delusions, auditory and visual hallucinations, irritability, insomnia, and rapid speech. She was in antidepressant treatment with 100 mg/day sertraline for 2 years and was euthymic for the last 18 months. In her history, she never had symptoms of mania or hypomania or any psychiatric admission before. In the first mental status examination, the Young Mania Rating Scale (YMRS) score was 33. On the twenty-eighth day of the hospitalization, the patient was discharged with the treatment of olanzapine 20 mg/day and clonazepam 0.5 mg/day since her YMRS score improved to 14. In spite of the fact that the core components of varenicline associated mania stay subtle, the present case report features the significance of monitoring for potential adverse reactions with the use of varenicline in patients with a history of depression, particularly when utilized in combination with antidepressants.

INTRODUCTION[|]Vaginismus is defined as female sexual pain disorder with recurrent or persistent involuntary contraction of the outer third of the vagina and presence of fear for intercourse Commonly, no organic causes can be implicated in etiology but various psychogenic factors are being examined. In this study, the patients with vaginismus is compared with healthy control in terms of obsessive beliefs, pysical and mental functioning, for the aim of uncovering the role of obsessive belief and functionality as a psychosocial factor in vaginismus.[¤]METHODS[|]Thirthy-seven women with vaginismus and 32 controls who have no difficulty with vaginal penetration were involved in this study. Golombok-Rust Inventory of Satisfaction Scale (GRISS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Obsessive Beliefs Questionnarie-44 (OBQ-44), Short Form 36 (SF-36) were administered to all participants.[¤]RESULTS[|]Subscores of vaginismus in GRISS, BDI and BAI were significantly higher in patients with vaginismus than the healthy control. Subscales of OBQ-44 including responsibility/threat estimation, perfectionism/certainty and importance/control were significantly higher in patients with vaginismus. The physical functionality was higher in patients with vaginismus. OBQ-perfectionism/certainty subscale was positively correlated with GRISS-avoidance subscale, OBQ-responsibility/threat estimation was positively correlated with GRISS- satisfaction subscales. [¤]DISCUSSION AND CONCLUSION[|]: Obsessive beliefs were higher in patients with vaginismus than the healthy control. Physical functionality was better in patients with vaginismus. Level of anxiety and depression were higher in patients with vaginismus. This study indicates the role of obsessive beliefs and anxiety smptoms in development and maintenance of vaginismus and absence of impact on quality of life.[¤]

Amaç: Bu çalışmada psikiyatri polikliniğine ayaktan başvuranhastalarda cinsel işlev bozukluğu (CİB) sıklığı ve CİB ile sosyodemografikveriler arasındaki ilişkinin araştırılması amaçlanmıştır.Yöntem: Çalışmaya tarama sorularını içeren formu doldurmayı kabuleden 369 kadın ve 232 erkek hasta alınmıştır. Olası bir CİB olduğu düşünülen275 kadın ve 145 erkek hastadan görüşmeyi kabul eden 172 kadın ve 83 erkekhasta ile görüşülmüştür. DSM-V tanı kriterlerine göre klinik görüşme ile CİBtanısı konulmuştur.Bulgular: CİB sıklığı kadınlarda %67.4, erkeklerde %53 oranındatespit edilmiştir. Kadınlarda sosyodemografik verilerden 38 yaş üzerinde olanlarda, çocuk sayısı üç ve üzerinde olanlarda,evlilik süresi 15 yıl ve üzerinde olanlarda CİB anlamlı olarak daha yükseksaptanmıştır (sırasıyla; p=0.034, p=0.007, p=0.015). Erkeklerde isesosyodemografik veriler ile CİB arasındaistatistiksel olarak anlamlı bir ilişki saptanmamıştır. Sonuç: Çalışmamızda CİB’in psikiyatri polikliniğine başvuran kadınve erkek hastalarda oldukça sık görüldüğü tespit edilmiştir. Ek olarak CİB’in kadınlardasosyodemografik verilerden yaş, çocuk sayısı, evlilik süresi ile ilişkiliolduğu tespit edilmişken, erkeklerde ise sosyodemografik verilerle ilişkisitespit edilmemiştir., Objective : Theaim of this study was to examine the prevalence of sexual dysfunction (SD) andthe relation of between SD with sociodemographic variables in patients.Method: The studyincluded 369 female and 232 male patients who agreed to fill up theform. 275 women and 145 men gave answers suggesting a possible SDand 172 women and 83 men among those agreed to make a clinical interview. SDwas diagnosed according to clinical interview based on DSM-V criteria for SD. Results: The prevalence of SD was 67.4% in womenand 53% in men according to DSM-V. The prevalence of SD was higher among womenwho were above 38 years of age, who hadat least three children, who have been married for more than 15 years (respectively; p=0.034, p=0.007 p=0.015).There was no significant difference between the patients with SD in terms of sociodemographicalvariables in men. Conclusion: In our study it has been found that, SDwas quite common among both female and male outpatients who applied to thepsychiatry clinic. In addition, it has been found that SD in women was associatedwith sociodemographic variables such as age, number of children, duration of marriage,however, the relationship with sociodemographic variables wasn’t determined inmales.

Bu çalışmanın iki amacı vardır; birincisi, Genişletilmiş Neo-Klasik Büyüme Modeline dayanan bütüncül bir üretim fonksiyonunu temel alarak 1965-2015 yılları arasında ARDL yaklaşımı ile Türkiye’de uzun dönem ekonomik büyümenin temel belirleyicilerini araştırmaktır. İkincisi ise ARDL yöntemi ile elde edilen sonuçları yeni eş-bütünleşme metotlarından olan FMOLS, DOLS ve CCR yöntemlerinden yararlanarak doğrulamak ve elde edilen sonuçların güvenilirliğini artırmaktır. Ampirik bulgular Türkiye’de uzun dönem ekonomik büyümenin temel belirleyicilerinin sermaye stokundaki ve enerji tüketimindeki artışların olduğunu ortaya koymaktadır. Ayrıca sonuçlar, literatürün aksine, beşeri sermayenin ekonomik büyümeye katkısının olmadığını veya varsa zayıf bir etkisinin olduğunu ifade etmektedir.

Antipsychotic drugs can cause neutropenia which can progress to life-threatening agranulocytosis. Clozapine is well-known for this side effect which is rare for other antipsychotics. Quetiapine is ...

WOS: 000457713600003, The aim of this article is twofold: First, it examines the asymmetric effects of industrial production, money supply and RER on stock returns in Turkey by using the non-linear autoregressive distributed lag (NARDL) model over the periods of 1994:01-2017:05 and 2002:01-2017:05. Second, it tries to determine whether there is a change of these macroeconomic variables' effects on stock returns after the 2001 financial crisis since after 2002 period represents a structural break from the past in terms of economic, political and macroeconomic policy approaches. The study finds that the effects of the changes in industrial production, money supply and RER on stock returns are asymmetric, and the asymmetries are larger after the 2002 subsample compared to the full sample period. The empirical results further suggest that tight monetary policies appear to retard the stock returns more than easy monetary policies that stimulate them.

PURPOSE The aim of the study was to assess efficacy and safety of paliperidone palmitate (PP) in schizophrenic patients using real-life data. METHODS This national, multicenter, retrospective, and mirror-image study was performed reviewing the medical records of patients in 18 centers. Adult schizophrenic patients receiving PP treatment (n = 205) were enrolled. Patients' data covering the last 12 months before the initial PP injection and the period until the end of study with at least 12 months after the initial PP injection were evaluated. Patients' characteristics, scale scores, and adverse events were recorded. RESULTS Nonadherence to prior medication was the most frequent reason for switching to PP treatment. Comparing with the period before PP treatment, the rate of patients visiting the hospital for relapse (79.5% vs 28.9%, P < 0.001) and the median number of hospitalizations (2 vs 0, P < 0.001) were lower during PP treatment. During PP treatment, the Positive and Negative Syndrome Scale score decreased by 20% or more (response to treatment) in 75.7% of the patients. The frequency of adverse events did not differ between the period before and during PP treatment. Improvement in functionality was higher in those with disease duration of 5 years or less. CONCLUSIONS Paliperidone palmitate is effective and safe in treatment of schizophrenic patients and in switching to PP treatment in patients with schizophrenia, which reduced the percentage of patients admitted to the hospital for relapse and the median number hospitalization, and has positive effects on functionality.

Fibromyalgia (FM) is a rheumatological diseases characterized by diffuse pain and stiffness accompanied with fatigue, insomnia and headache. Physical and psychological factors were implicated in sexuality of patients with FM. There are few studies investigating the effect of childhood trauma on sexuality of patients with FM. The aim of this study is to investigate effect of childhood trauma on sexuality of FM.Thirty-six patients with FM and 29 healthy females were included in this study. The patients with FM and healthy controls were assesed in terms of sociodemographic and clinical variables, sexual function and childhood traumas.The healthy controls had significantly longer duration of marriage with higher rate of marriage by arrangement. Communication subscale score was significantly higher in patients with FM. General and emotional trauma scores were significantly higher in patients with FM. There was no correlation between the scores of GRSSS, CTQ and FIQ.The type of marriage and duration of marriage were important sociodemographic variables concerning sexuality in FM. This study indicated that childhood trauma was not a related factor in sexuality of FM.

This paper aims to investigate the short-run and long-run macroeconomic determinants of the Turkish stock returns under the impact of the “domestic and global economic policy uncertainty” by using the ARDL method and the monthly data for the period of 1991:M1 to 2017:M12. The set of macroeconomic variables utilized in the study are the stock market price indexes of Turkey’s BIST100 index (BIST) and the BIST industrial index (IND), industrial production index (IPI), real effective exchange rate (RER), consumer price index (CPI), interest rate (R), Geopolitical risk index for Turkey (GPR) and the Economic Policy Uncertainty index of the United States of America (EPU). The ARDL estimation results reveal that in the short-run the BIST stock returns are positively affected from the changes in IPI, RER and CPI. The effects of the changes in Turkish interest rate (R), EPU and the dummy representing the impact of the 2008 Global Financial Crisis on the stock returns are negative. The long-run determinants of the BIST stock returns are the changes in IPI, RER, and CPI and the EPU. The effect of the changes in the EPU on the stock returns is negative and the effect of the other variables are positive., Bu makalenin amacı yerel ve global ekonomik politika belirsizliği altında Türkiye’de hisse senedi getirilerinin belirleyicilerinin hangi makroekonomik değişkenler olduğunu ARDL metodu ve 1991-2017 yılları arası dönemde aylık veriler kullanarak belirlemektir. Çalışmada; bağımlı değişken olarak Borsa İstanbul’un BIST100 (BIST) ve Endüstri endeksleri (IND) ve bağımsız değişkenler olarak da Türkiye imalat sanayi endeksi (IPI), reel döviz kuru (RER), tüketici fiyat endeksi (CPI), faiz oranı (R), Türkiye’nin jeopolitik risk endeksi (GPR) ve ABD’nin ekonomik politika belirsizliği (EPU) verilerinden yararlanılmıştır. ARDL tahmin sonuçları, kısa dönemde BIST hisse senedi getirilerinin belirleyicilerinin pozitif olarak IPI, RER ve CPI; negatif olarak da R, EPU ve 2008 global finansal krizini temsil eden “kukla değişkeni” olduğunu ortaya koymaktadır. Uzun dönemde ise IPI, RER ve CPI’daki değişmeler pozitif, EPU’daki değişmeler ise hisse senedi getirilerine negatif etki etmektedir.

Bipolar disorder is a chronic disease characterized by recurring episodes of mania and depression that can lead to disability. This study investigates the protective effects of edaravone (3-methyl-1-phenyl-2-pyrazolin-5-one), a drug with well-known antioxidant properties, in a model of mania induced by ketamine in rats. Locomotor activity was assessed in the open-field test. Superoxide dismutase (SOD), catalase (CAT) and thiobarbituric acid reactive substances (TBARS) levels were measured in order to evaluate oxidative damage in the rat hippocampus and prefrontal cortex. Increased locomotor activity (hyperlocomotion) was observed at the open-field test with ketamine treatment (25 mg/kg, i.p., 8 days). Edaravone (18 mg/kg) treatment did not prevent hyperlocomotion in the mania model induced with ketamine in rats, but lithium chloride (47.5 mg/kg, i.p., positive control) did prevent hyperlocomotion. Edaravone and lithium chloride treatments were found to reduce the increase in SOD and CAT activity following ketamine administration in a non-significant manner but caused no change in TBARS levels.

Objective Impairment in immune functions is proposed as a key factor in the cognitive decline in bipolar disorder (BD) however there is scarcity of research on the impact of inflammation on cognitive functions. Our aim is to compare IL-18 and IL-6 levels in BD patients and controls and to study the relationship between IL-18 and IL-6 levels and cognitive impairment METHOD: Thirty-six euthymic BD-I patients and 38 age, sex and educational level matched healthy controls were enrolled in the study. All participants were evaluated with neurocognitive tests. The plasma IL-6 and IL-18 levels of both groups were measured with ELISA kits. Results There was no statistically significant difference between IL-6 and IL-18 levels of patient and healthy control groups. In the patient group, IL-18 level was positively correlated with completed categories score wheras there was a negative correlation with perseverative response and perseverative errors. Moreover IL-18 level was positively correlated with immediate recall, delayed recall and learning scores while there was a negative correlation with stroop interference scores. No correlation was found between IL-6 level and neuropsychological test scores in the patient group. Conclusion This is the first study that investigates the relation of IL-18 with cognitive functions. Possible detrimental or protective effects of IL-18 in BD is not yet clear, however the positive association of IL-18 level and neuropsychological test scores might indicate a neuroprotective role of IL-18 in the euthymic period of BD which is the closest state to physiological condition.

Objective High suicide risk was shown to be related with depression and low quality of life in studies investigating clinical variables related to suicidal behavior. The aim of this study was to investigate the effects of a suicide attempt on clinical presentation by comparing sociodemographic variables, clinical signs, symptoms of depression, quality of life, social functionality, and reported adverse drug reactions in schizophrenic patients with and without suicide. Method Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale (CDS), Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), Social Functioning Scale (SFS), and Udvalg for Kliniske Undersogelser Side Effect Rating Scale (UKU) were administered to 115 patients with schizophrenia. Results 44.3% of patients had at least one suicide attempt. Among sociodemographic variables, a family history of suicide, smoking, and total duration of disease were significantly higher in patients with suicide history than without. Scores of CDS and UKU subscores were significantly higher, and quality of life and social occupation in social functionality were significantly lower in patients with a history of suicide. In correlation analysis, CSD was negatively correlated with Q-LES-Q and independency/performance subscore of SFI, and positively correlated with UKU-Neurological subscore. Discussion In line with this data, suicidal behavior may be suggested to affect clinical presentation and course characteristic of schizophrenic patients. Additional treatments towards factors that may impact on the clinical course and social support programs might be suggested for these patients.

This study investigates the causal relationshipbetween selected domestic and international macroeconomic variables and thestock returns in Turkey by using ARDL methodology for the period of2003:1-2016:12. By taking S&P500 and World Oil Price Index as exogenouscontrol variables, the study finds that the main determinants of Turkish stockreturns are the changes in industrial production index, consumer price index ,current account to export ratio, real effective exchange rate, Standard &Poor's 500 Index, World Oil Price Index and the interest difference betweenTurkish Central Bank policy rate and the Federal Funds Rate of the USA in thelong-run. The signs of industrial production index , consumer price index,current account to export ratio, real effective exchange rate, S&P500 andWorld Oil Price Index are statistically significant and positive and the signof the interest difference between Turkish policy rate and the FFR is negative.The test results also show that Turkish unemployment rate does not have anyeffect on Turkish stock returns., Bu çalışma aylık verilerden ve ARDL yaklaşımındanyararlanarak 2003 ile 2016 yılları arasında seçilmiş makroekonomikdeğişkenlerle hisse senedi getirileri arasındaki nedensellik ilişkisiniaraştırmaktadır. S&P500 ve dünya petrol fiyat endeksini dışsal kontroldeğişkenleri olarak kullanarak, bu çalışmanın ampirik test sonuçları uzundönemde hisse senedi getirilerinin temel belirleyicilerinin imalat sanayiendeksi, tüketici fiyat endeksi, cari işlemler hesabının ihracata oranı, reelefektif döviz kuru, TCMB politika faizi ile FFR farkından oluşan faiz oranlarıfarkı, S&P500 ve dünya petrol fiyat endeksi olduğunu ortaya koymaktadır.Ampirik test sonuçları, BIST hissesenedi getirileri ile tüketici fiyat endeksi, cari işlemler hesabının ihracataoranı, reel efektif döviz kuru, S&P500 ve dünya petrol fiyat endeksiarasında istatistiksel olarak anlamlı ve pozitif, TCMB politika faizi ile FFRfarkından oluşan faiz oranları farkı arasında ise istatistiksel olarak anlamlıve negatif bir ilişki olduğunu ortayakoymaktadır. İşsizlik oranındaki değişmelerin hisse senedi getirilerine biretkisi yoktur.

Summary Objectives: Mental state of the patients with epilepsy has been evaluated in various studies. Psychiatric comorbidities are known to be relatively frequent in patients with epilepsy. The aim of this study was to compare the psychopathological features of female patients with conversion disorder (CD) and epilepsy with nonintractable seizures with healthy controls. Methods: The sample recruited from psychiatry and neurology outpatient clinics in a tertiary care center. The study population consisted of 32 female patients with CD, 30 female patients with epilepsy and 31 female healthy controls with similar age and education levels. The psychopathological state was assessed by clinical measures including Brief Symptom Inventory, Somatosensory Amplification Scale and a sociodemographic data form. Results: Sociodemographic features did not differ between the groups. The subscales of Brief Symptom Inventory were significantly higher in patients with conversion disorder than epilepsy, and in patients with epilepsy than the healthy control. But Somatosensory Amplification Scale differ significantly only between patients with conversion disorder and healthy control. Conclusion: The psychopathological features of three groups differed in most of the items. More severe psychopathological symptoms in epileptic patients than the healthy control but milder than Conversion Disorder may imply that mental state of patients with epilepsy is determined by different factors other than the clinical factors related with seizure.

Cognitive dysfunction in bipolar disorder (BD) is well established in the literature. The neurocognitive deficits have been considered to be endophenotypic markers of BD, and studies have examined whether neurocognitive deficits exist in first-degree relatives of individuals with BD I. We hypothesized that performance in tests of neurocognitive function would be impaired in euthymic BD I patients and their unaffected first-degree relatives compared to that of healthy controls.We compared the performance of bipolar patients, their first-degree relatives, and healthy controls in a battery of neurocognitive tests to reveal possible endophenotypes of BD. A diagnostic interview and neuropsychological test battery were administered to 30 BD I patients, 55 of their unaffected first-degree relatives and 32 healthy controls.The patients and their first-degree relatives were significantly impaired in executive function assessed using the Wisconsin Card Sorting Test (WCST) and Trail Making Test-B (TMT-B) relative to the controls (WCST; perseverative errors: p0.0005, categories completed: p = 0.002, TMT-B; p = 0.002). There were no significant differences between the groups in terms of attention, psychomotor speed, verbal memory, or learning.Our study suggests that the deficits in executive function may be endophenotypic markers of genetic vulnerability to BD I.

OBJECTIVE Maintenance treatment with antipsychotic drugs for patients with schizophrenia is highly effective in decreasing the recurrence rate of the disease. In the current study, we aimed to compare long-acting second generation antipsychotic drug injections and oral forms of second generation antipsychotic drugs in terms of their adverse effects on quality of life. METHOD Forty-one patients receiving second generation antipsychotic drugs and 139 patients diagnosed with schizophrenia or schizoaffective disorder were treated with oral second generation antipsychotic drugs and enrolled in the study. All patients were evaluated with Positive and Negative Symptoms Scale (PANNS), extrapyramidal symptom rating scale (ESRS) and UKU, and Quality of Life Enjoyment and Satisfaction questionnaire (Q-LES-Q). RESULTS The impact of adverse effects of oral second generation antipsychotic drugs on the daily performance of patients with schizophrenia or schizoaffective disorder was found to be significantly higher than that of the long acting injection antipsychotic drugs. The quality of life of patients receiving long acting second generation antipsychotic drug injection was significantly higher when compared with that of the patients treated with oral second generation antipsychotic drugs. CONCLUSION The results of this study showed that the long-acting second generation antipsychotic injection treatment was superior to second generation oral forms of antipsychotic drugs in terms of adverse effects and measures of quality of life. Further studies with specific design and the supplementation of larger samples are needed.

Aim: Schizophrenia (SCH) and bipolar affective disorder (BAD) are currently classified separately according to the DSM (The Diagnostic and Statistical Manual of Mental Disorders) and ICD (International Statistical Classification of Diseases and Related Health Problems) standardized diagnostic guidelines. However, the validity of this categorical approach is controversial because psychotic symptoms may be observed in both diagnoses. The purpose of this study was to compare the clinical and social characteristics in a sample group consisting of patients diagnosed with SCH or BAD to help demonstrate the basic difficulty in the current classification of SCH and BAD as two etiologically distinct diseases. Subjects and methods: The study sample group consisted of 102 patients diagnosed with SCH and 92 patients diagnosed with BAD. All of the participants were evaluated by Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition with regard to beginning symptoms of the disease, the symptoms and signs of active disease period within total disease duration, continuining residual symptoms in intermediate period. The patients were administered the Positive and Negative Syndrome Scale, the Quality of Life Enjoyment and Satisfaction Questionnaire and the Social Functioning Scale. Results: The SCH and BAD groups in this study were statistically similar in terms of sex, length of education, age at disease onset, attempted suicide, quality of life and social functioning. Conclusion: Our study findings indicated that the course of disease in patients with BAD-1, in which psychotic features predominate and which exhibits a recurring course, shares various characteristics with SCH. It can be concluded that further phenomenological and neurobiological evaluations are required for intermediate cases with similiar clinical characteristics with schizophrenia and bipolar disorders.

Objective The aim of this study was to investigate the relationship of the different dimensions of insight with clinical variables, symptom severity, and cognitive functions in patients with schizophrenia. Method In this cross-sectional descriptive study, 66 out patients that applied to the Karadeniz Technical University, Psychiatry Clinic and were diagnosed with schizophrenia according to DSM-IV were evaluated. The patients were evaluated with Structured Clinical Interview for DSM (SCID-I), the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS), and the Schedule for Assessing the Three Components of Insight (SAI). Wisconsin Card Sorting Test, Verbal Fluency Test, Trail Making Test A and B and Rey Auditory Verbal Learning Test were applied to assess the cognitive function of each patient. Results The insight levels of the patients that were evaluated with SAI were found to be correlated with PANSS positive, negative, and general psychopathology symptom severity as well as Verbal Fluency Test and Trail Making Test A and B scores. In the multiple linear regression analysis, PANSS positive, Verbal Fluency Test and Trail Making Test A scores were determined the contributors of SAI total score. Conclusions The relationship between insight and clinical symptoms may change depending on the course of the disease and severity of symptoms. These findings emphasize the importance of frontal executive function in the relationship between insight and cognitive functions.

Background and Design: Although alopecia areata is not yet clearly shown to be triggered by emotional stress, neuroendocrinologic studies supports that psychological stress may be effective in the disease process. In this study we aimed to show the role of stressful life events in onset and exacerbation of alopecia areata and the levels of anxiety, depression and quality of life by the comparison with the patients with androgenetic alopecia and healthy controls.Materials and Methods: Thirty-one consecutive patients with alopecia areata (13 females, 18 males, mean age 28.1±8.9) were included in this study. Forty-six patients with androgenetic alopecia (24 females, 22 males, mean age 28.2±7.4) and 45 healthy individuals (25 females, 20 males, mean age 25.4±4.4) was created as the two control groups. The patients and the control groups completed the tests including life events scale, Beck depression inventory, Beck anxiety inventory and Skindex-29 scales.Results: Total scores of the scale of life events in patients with alopecia areata were significantly higher than in healthy controls (p=0.031). There were also significant differences in the sub-units -distress and adaptation- scores of this scale (p=0.028; p=0.036). The scores of Beck depression inventory were significantly higher than control group (p=0.014), however they were identical to the patients’ with androgenetic alopecia. The scores of Beck anxiety inventory of all three groups showed no significant difference (p=0,207). The quality of life in patients with alopecia areata which is evaluated with Skindex-29 is severely impaired according to the scores of all three sub-units of this test -symptomatic, functional, and emotional- (p=0.001; p

Objective: Changes in NO synthesis have been shown in studies regarding NO function in mood disorders, schizophrenia, autism, obsessive compulsive disorder and Alzheimer's disease. The aim of this ...

Aim: Characteristically, the onset of bipolar disorder is the early adulthood and the first episode affects women of childbearing age. The studies indicate that 60-70 % of women with bipolar disorder experince mood symptoms during the periods of pregnancy and/or postpartum. The aim of the present study is to reveal the risk of bipolar disorder in pregnancy and the risk of bipolar disorder among pregnant women who had positive screening for prenatal depression. Methods: The study involved 347 literate pregnant women between the ages of 18-50. All patients were screened with self-report scales of Edinburgh Postnatal Depression Scale (EPDS) and Mood Disorders Questionnaire (MDQ). Results: Of the 347 women participating in the study, completed both scales. Of the participants, 52 (16.5%) EPDS scale was found to be positive while 27 (8.5%) MDQ scale was positive. Diagnosis of bipolar disorder was considered in 3 (%11.1) out of 27 individuals who had MDQ score of 7 or above by a clinical interview with SCID-I. The results also indicated that the probability of positive EPDS screening is significantly higher than negative screening in participants with positive MDQ screen (p

Valproic acid (VPA) is used as a mood stabilizer in the treatment of bipolar disorder and is commonly associated with central nervous system side effects. The most common side effect is tremor due to dose, while Parkinsonism is a less common side effect. Among psychiatric patients, there are few reports of recurrent Parkinsonism attributed to VPA. However, in the literature, especially among neurological patients, VPA is one of the main important causes of Parkinsonism. Furthermore, the relationship between VPA treatment dose and Parkinsonism symptom severity is uncertain. 72-year-old male patient has been followed up for 30 years with a diagnosis of bipolar disorder and has been receiving a treatment of VPA. After VPA treatment was started, complaints of impairment in speech, walking with small steps, slowed movements and imbalance which had gradually increased, started within the last 10 years. The patient was admitted to the clinic and assessed for secondary parkinsonism. VPA treatment of the patient was stopped since he was thought to have secondary Parkinsonism associated with medication. 4 days after the VPA medication was stopped, it was seen that there was a decrease in the bent forward posture and regression in dysphagia and the patient was seen to walk alone without any support. Based on this case, it can be put forward that addressing psychiatry patients who have a long-term use of VPA in terms of Parkinsonism symptoms can be significant in terms of not overlooking this side effect that can disrupt the quality of life and also in terms of early diagnosis and treatment.

Background Needs based biopsychosocial distress instrument for cancer patients (CANDI) is a scale based on needs arising due to the effects of cancer. Objectives The aim of this research was to determine the reliability and validity of the CANDI scale in the Turkish language. Patients and Methods The study was performed with the participation of 172 cancer patients aged 18 and over. Factor analysis (principal components analysis) was used to assess construct validity. Criterion validities were tested by computing Spearman correlation between CANDI and hospital anxiety depression scale (HADS), and brief symptom inventory (BSI) (convergent validity) and quality of life scales (FACT-G) (divergent validity). Test-retest reliabilities and internal consistencies were measured with intraclass correlation (ICC) and Cronbach-α. Results A three-factor solution (emotional, physical and social) was found with factor analysis. Internal reliability (α = 0.94) and test-retest reliability (ICC = 0.87) were significantly high. Correlations between CANDI and HADS (rs = 0.67), and BSI (rs = 0.69) and FACT-G (rs = -0.76) were moderate and significant in the expected direction. Conclusions CANDI is a valid and reliable scale in cancer patients with a three-factor structure (emotional, physical and social) in the Turkish language.

Kleine-Levin Syndrome (KLS) is a rare disorder characterized intermittent hypersomnia, hyperphagia, hypersexuality, abnormal behaviors, and confusion. Patients are asymptomatic between episodes. The aim of this case series study was to determine the clinical features of patients with KLS and to compare the polysomnography (PSG) findings between symptomatic and asymptomatic periods. We compared the results of PSG investigations performed in symptomatic and asymptomatic periods in six patients diagnosed with KLS at Gulhane Military Medical Faculty Sleep Research Center between 1998 and 2005. The age at onset of KLS was approximately 18 years, the diagnosis delayed 2.67 years, hypersomnia episodes lasted approximately 11.5 days, until the correct diagnosis, the patients had experienced on average 5 episodes. Total sleep time in KLS patients during symptomatic period and stage 2 sleep percent was higher than in asymptomatic period. REM latency was shorter and stage 3 and REM percent was lower in asymptomatic period. The clinical features including the age of onset and episode duration are compatible with those from the previous studies. It was observed that the sleep architecture during symptomatic period was different from that in asymptomatic period.

This study aimed to determine the prevalence of Night Eating Syndrome (NES) among overweight or obese patients with serious mental illness and its relationship with insomnia and quality of life.This study included 158 overweight or obese patients diagnosed with schizophrenia, schizoaffective disorder, and bipolar disorder (according to DSM-IV criteria) that were not in the active disease period. A clinical interview and Night Eating Questionnaire (NEQ) were used to assess the prevalence of NES among those in the study group. Body mass index (BMI), sleep quality, and quality of life measures were also evaluated for each patient.Twelve patients (7.6%) were diagnosed with NES via clinical interview while 26 (16.5%) were diagnosed by having ≥25 points in the NEQ. There were no statistically significant differences between the NES and non-NES groups with respect to age, gender, education and body mass index. However, quality of life scores were lower while the severity of insomnia scores were higher in patients with NES.The prevalence of NES is higher among overweight or obese patients with serious mental illness when compared to prevalence data in a general population, as demonstrated by previously published studies. Night eating behavior may be related to insomnia and poor quality of life measures. The recognition of NES among patients with severe mental disease is essential to promote prevention of obesity and insomnia as related to night eating behavior.

WOS: 000455891800011 Objective: Attention-deficit hyperactivity disorder (ADHD) with other psychiatric comorbidities in adulthood is challenging in terms of differentiating the neuropsychological impairments in each disorder. Executive functions have been widely studied and shown to be consistently impaired in ADHD. However, there is a lack of knowledge about which executive function deficits are attributable to ADHD and which of them are assosciated with comorbid psychiatric disorders. Thus, the aim of this study was to investigate to what extent the deficits in executive functions are attributable to ADHD rather than comorbid psychiatric diseases among adult patients with ADHD. Methods: Adult patients diagnosed with ADHD and comorbid psychiatric disorders (n=26) were compared with psychiatric patients without ADHD (n=26) and healthy subjects (n=26) matched for age, sex, and duration of education. Adult ADHD Self-Report Scale, Wender Utah Rating Scale for the ADHD and Structured Clinical Interview for DSM-IV Axis I Disorders screened all participants. In addition, Wisconsin Card Sorting Test computer form, Rey Auditory Verbal Learning Test, and the Stroop Color Word Test were used for neuropsychological assessment. Results: Adults psychiatric patients with ADHD scored lower than those without ADHD in terms of measures of inhibition, attention, planning, set-shifting, problem-solving, verbal learning, and verbal memory. Psychiatric patients without ADHD scored significantly lower than healthy controls in terms of planning and problem solving. Conclusions: Our findings suggest that the ADHD, rather than comorbid psychiatric disorders, is the significant underlying cause for executive function deficits in inhibition, attention, set-shifting, verbal learning, and verbal memory.

Objective: Previous research has suggested that metabolic syndrome is more prevalent among patients with schizophrenia and bipolar disorder. Given the scarcity of comparative research on these disorders, this study aims to compare the prevalence of metabolic syndrome in two diagnostic groups and to identify sociodemographic or clinical factors related to metabolic syndrome. Methods: A total of 235 patients diagnosed with schizophrenia (n=160) and bipolar disorder (n=75) and were being followed up by a metabolic monitoring program in a specialized outpatient clinic and using antipsychotic therapy for at least eight weeks have participated in this cross-sectional study. Patients were diagnosed with metabolic syndrome according to National Cholesterol Education Program Adult Treatment Panel-III (NCEP ATP-III) criteria. Sociodemographic and clinical data including metabolic records were collected retrospectively by reviewing the patients’ medical records. Results: The overall prevalence of meta-bolic syndrome was 32.3% and waist circumference was the most frequent individual component with a prevalence of 60%. There were no differences in the prevalence of metabolic syndrome between schizophrenia and bipolar patients. Age, body mass index (BMI), and use of certain types of atypical antipsychotics were found related to metabolic syndrome. Conclusion: The prevalence of metabolic syndrome and its components among patients with severe mental illness is alarming irrespective of their diagnoses. Thus, metabolic screening is crucial especially for high-risk groups.

Trazodone is a heterocyclic antidepressant that exerts its effect via the inhibition of selective serotonin reuptake and the antagonism of 5-HT2A and 5-HT2C receptors. Antidepressant-induced galactorrhea and increases in prolactin levels have rarely been reported. Trazodone can potentiate the serotonergic activity of citalopram. To our knowledge, no cases of galactorrhea associated with use of trazodone have been reported to date. This report describes a unique case of the development of galactorrhea following the addition of trazodone (100 mg/day, 2 weeks) to the treatment of a patient who was receiving citalopram (40 mg/day, 6 weeks) therapy for a diagnosis of depressive disorder, which improved upon the discontinuation of trazodone.

Stylized Business Cycle facts show that employ‐ment is highly procyclical and unemployment is highly countercyclical with the aggregate eco‐nomic activity. Also, Okun’s law indicates a negative relationship with between economic growth and unemployment rate. This paper’s goal is to find out what causes high unemploy‐ment and what is the relationship between economic growth and unemployment in Turkey. It aims to show not only the relationship be‐tween cyclical output and unemployment, but also how the changes in GDP gap affect the unemployment. Further, it analyzes whether the relationship between GDP gap and Unemploy‐ment is symmetric. The results of the Granger causality test indicate that there is a unidirec‐tional causality from GDP gap to Unemployment. Also, impulse response and Variance decomposi‐tions show that following the crises, although there is a strong and quick recovery in economic activity, but same recovery is not seen in em‐ployment and in the reduction of unemployment rate. This can be seen as a typical indication of Anahtar Kelimeler: “jobless growth” phenomena. The paper also discusses the micro and macro policy measures for reducing unemployment., Konjonktürel dalgalanma gerçekleri ve Okun kuralı işsizliğin toplam ekonomik aktivite ile ters yönlü hareket ettiğini ortaya koyar. Bu makale‐ nin amacı Türkiyede son zamanlarda ortaya çıkan yüksek işsizliğin nedenini ve ekonomik aktivite ile nasıl bir ilişkisinin olduğunu ortaya koymaktır. Bunu yaparkende sadece bu ilişkiyi araştırmayıp, toplam çıktı açığındaki değişme‐ lerin (GDP Gap) işsizliği ve oranını nasıl etkiledi‐ ğini ve ilişkinin simetrik olup olmadığını ortaya koymaktır. Granger nedensellik testleri ilişkinin tek yönlü v eve toplam çıktı açığından işsizliğe doğru olduğunu ortaya koymaktadır. Impulse response ve Variance decompositions uygulamaları da Granger nedensellik testi ile elde edilen sonuçları desteklemektedir. Çalışma sonuç olarak isşizliğin azaltılması için mikro ve makro çözüm önerileri sunmaktadır.

Alliance Capitalism for the New American Economy advocates engagement with the USA's macromanagement problems in a spirit of alliance capitalism, for the development of a more integrated, dynamic economy. Whereas most studies of the USA emphasise the efficiency effects of intense competition between firms, this book stresses that as the new economy becomes more knowledge based, its development necessitates active intercorporate cooperation, especially in high technology sectors.

Objective: Function of NO and its intra-system competitive inhibitor of the nitric oxide, asymmetric dimethylarginine (ADMA) has been investigated in mood disorders, schizophrenia, autism, obsessive compulsive disorder and Alzheimer Disorder and significant results were obtained. The mechanism of action in mood stabilizators is still unclear despite many years of studies. The parameters of oxidative stres were shown to decreased upon antimanic treatment in bipolar affective disorder (BAD). The lithium may be suggested to produce neuroprotective effects against oxidative damage by regulatory effects towards various targets. The effects of lithium on nitric oxide synthase were researched in laboratory studies. In this study, two tubes of plasma were taken from the patients for determination of NO and ADMA during manic and euthymic phases. Methods: Seventeen patients who presented to the psychiatry or emergency departments of Farabi Hospital of Karadeniz Technical University and were diagnosed with BAD-I manic episode and followed with lithum were included into the study. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Hamilton Depression Rating Scale (HAM-D), Young Mania Rating Scale (YMRS), Montgomery-Asberg Depression Rating Scale (MADRS), were applied. For determination of NO and ADMA levels, two tubes of plasma were collected during the periods of mania and euthymia in the patient group. Results: The level of ADMA were significantly lower while the level of NO were higher in the posttreatment group than the pretreatment group. Conclusion: In this study, the level of NO were increased, the level of ADMA were dicreased in response to lithium treatment, and the therapeutic effect of lithium may contribute this mechanism.

The aim of this study was to compare people with substance use disorder with healthy controls in terms of childhood abuse, proclivity towards substance abuse, coping skills and self-esteem as well as the correlation between experiences of abuse in childhood and these variables.The study group included 41 subjects diagnosed with substance use disorder, who had been sentenced under the respective laws as a result of crimes relating to substance use and possession, and the control group. A sociodemographic Data Form, SCID-I, Childhood Trauma Questionnaire, COPE, Substance Abuse Proclivity Scale and Rosenberg Self-Esteem Scale were applied to all participants.Childhood trauma history was observed to be more common in the study group than in the control group. When the childhood trauma questionnaire was evaluated, the scores for physical abuse were found to be significantly higher in the study group. COPE subscale scores for mental disengagement, focusing on problems and expressing emotions, active coping, coping through religion and emotional social support usage were significantly lower in the study group. The study group's results on the Substance Abuse Proclivity Scale were found to be higher than those of the control group. On the Rosenberg Self Respect Scale, the study group's scores were higher while the control group was more likely to have high self respect.People with substance use disorder are more likely to have a childhood history of physical abuse, higher proclivity towards substance abuse and lower self esteem. The level of abuse increases the level of emotion-based coping while decreasing levels of problem-based coping. There is support for the view that that traumatic childhood experiences are one of the psychosocial risk factors related to, although not specific to substance use.

Sexuality is an important part of healthy life. Patients with ankylosing spondylitis (AS) may be vulnerable to sexual problems because of disease activity and comorbid emotional problems. However, sexuality is a scarcely studied subject in AS. The aim of this study is to compare patients with AS with healthy control. A total of 43 male patients, who referred to the Department of Physical Medicine and Rehabilitation Clinics of the Karadeniz Technical University Farabi Hospital between May 2010 and July 2010, and were diagnosed as AS according to modified New York criteria, were included in the study. Control group consisted of healthy 43 age-and sex-matched male individuals with normal inflammatory levels. The AS patients were compared in means of sociodemographic variables and sexual function with Glombok-Rust Sexual Satisfaction Scale (GRSSS) and clinical interview. Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) were used to determine anxiety and depression levels, respectively. The disease activity and functional conditions were evaluated with the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath Ankylosing Spondylitis Metrology Index (BASMI) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDI). A total of 43 patients with AS and 43 healthy heterosexual male were included in the study. The total GRSSS score was significantly higher in patients with AS, whereas they also had significantly higher sexual complaint than healthy control. The diagnosis of sexual dysfunction according to DSM-IV was significantly higher in the patients with AS as well as depression and anxiety. In study group, GRSSS total score was modestly correlated with disease activity. The psychological status had close relation with sexual functions in AS. Overall assessment is required for complete evaluation in patients with AS. International Journal of Impotence Research (2011) 23, 262-267; doi: 10.1038/ijir.2011.37; published online 4 August 2011 WOS:000296873400005 PubMed: 21814226

5 OZET: Trabzon ili ilko¤retim ca¤› cocuklar›nda dikkat eksiklii hiperaktivite bozukluu ve efllik eden y›k›c› davran›fl bozukluklar› yayg›nl›¤› Amac: Bu cal›flman›n amac› Trabzon ilinde ilko¤retim ca¤› cocuklar›nda Dikkat Eksiklii Hiperaktivite Bozukluu'nun (DEHB) ve ona efllik eden Y›k›c› Davran›fl Bozukluklar›'n›n (YDB) yayg›nl›¤›n› incelemektir. Yontem: Cal›flmada 6-12 yafl aral›¤›ndaki ilkokul o¤rencile- rinde (n=1126) DSM-IV tan› olcutlerine gore DEHB ve YDB tan›lar›n›n konulmas› amac› ile Turgay'›n Cocuk ve Ergen- lerde Davran›m Bozukluklar› icin DSM-IV'e Dayal› Tarama Olcei kullan›lm›flt›r. Bulgular: DEHB yayg›nl›¤› %8.6 (n=97) ve alt tip da¤›l›mla- r› dikkat eksiklii %1.6 (n=18), hiperaktif/ durtusel tip %6 (n=69) ve kombine %0.9 (n=10) olarak s›ralanm›flt›r. Erkek k›z oran› DEHB'nin tum alt tipleri icin 3.5/1 olarak bulun- mufltur. Orneklemde dier YDB yayg›nl›¤› %18.6 (n=209)'d›r. Karfl›t Gelme-Karfl› Olma Bozukluu'nun (KG-KOB) yayg›nl›¤› %14.1 (n=159) ve Davran›m Bozuklu- ¤u'nunki (DB) %4.4 (n=50) olarak belirlenmifltir. DEHB olan olgularda KG-KOB'nin s›kl›¤› %57.5 (n=56)ve DB'nin s›kl›¤› %20.6 (n=20)'d›r. Sonuc: Bu cal›flman›n sonuclar› DEHB yayg›nl›¤›n›n, erkek bask›nl›¤›n›n ve efllik eden YDB s›kl›¤›n›n kulturler aras›nda anlaml› bir farkl›l›k gostermedii goruflunu desteklemekte- dir. Ote yandan hiperaktif/ durtusel alt tipin da¤›l›m› litera- turde sunulan oranlardan farkl›l›k gostermektedir. Bu fark›n Turk toplumunda cocua yonelik yafla bal› tutumlar, yak- lafl›m oruntuleri ve beklentilerle iliflkili kulturel farklarla fle- killlenebilecei deerlendirilmifltir. Bu noktan›n kulturel farklara odaklanan ileri cal›flmalarla ac›klanmas› onerilmek- tedir. ABSTRACT: of attention deficit hyperactivity disorder and comorbid disruptive behavior disorders among school age children in Trabzon

Objective Schizophrenia presents with different symptom domains and functionality during its course. Obsessive-compulsive (OC) symptoms in schizophrenia have many themes to be clarified. Our aim was to compare schizophrenia patients with and without OC symptoms in terms of symptom domains, cognitive functions, and quality of life. Method Sixty-two patients who met schizophrenia diagnosis were assessed with Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition consecutively over a period of 12 months in the setting of an outpatient clinic at medical university hospital. Yale-Brown Obsessive-Compulsive Scale, Scale for the Assessment of Negative Symptoms, Scale for the Assessment of Positive Symptoms, and neuropsychologic tests were used. Quality of life was assessed with Quality of Life Scale for Patients with Schizophrenia. Results Obsessive-compulsive symptoms along with schizophrenia were present in a considerable number in our sample (35.5%). Level of psychotic symptoms was more severe and quality of life was lower in schizophrenia patients with OC symptoms. A positive correlation was found between obsessions and delusions. Moreover, there was a positive correlation between compulsions and total Scale for the Assessment of Positive Symptoms score and bizarre behaviors subscore. There was no difference between the 2 groups regarding neurocognitive functions. The level of quality of life of schizophrenic patients with OC symptoms was lower. Besides, no correlation was found between OC symptoms and neurocognition and quality of life. Conclusions The findings of this study indicate that schizophrenia patients with OC symptoms had severe psychotic symptoms with a distinctive clinical picture including good neurocognition but poor functioning.

IntroductionPrescribing more than one antipsychotic at the same time is becoming common in the treatment of patients with severe mental illness (SMI), although most guidelines recommend monotherapy.ObjectivesThe aim of this study was to examine the prevalence of antipsychotic polypharmacy and to compare the practices of polypharmacy and monotheraphy in terms of the rationale and compatibility of the treatment.MethodsThis study included 235 patients with SMI between 18 and 65 years of age who were followed at KTU Psychiatry Department Schizophrenia-Bipolar Disorder outpatient clinic between January 2007 and December 2014. The sociodemographic and clinical data were evaluated by a chart review form which was prepared by the researcher and designed according to American Psychiatric Association treatment algorithm and National Associated Mental Health Program Directors polypharmacy classification.Results138 patients (58.7%) were diagnosed with schizophrenia, 75 patients (31.9%) were diagnosed with bipolar disorder and 22 patients (9.4%) were diagnosed with schizoaffective disorder. 62 patients (26.4%) were receiving antipsychotic polypharmacy. Combinations of two second-generation antipsychotics were most common. Anticholinergic drug use was significantly more common in patients on antipsychotic polypharmacy. Reported adverse events were more common in patients on polypharmacy but did not reach the level of statistical significance. Patients on antipsychotic polypharmacy were more likely to be diagnosed with schizophrenia. Polypharmacy patients were also more likely to receive clozapine and amisulpride whereas monotherapy patients were more likely to receive olanzapine.ConclusionOur results confirm previous reports that indicate patients with SMI are most likely to receive antipsychotic polypharmacy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Objective: Vaginismus is a female sexual dysfunction with reflex spasm of the muscles around vagina making penile penetration impossible. Many factors such as psychological, social and cultural may cause vaginismus were proposed, but debates are still ongoing. In this study, factors that may be related with vaginismus were studied and compared with controls. Methods: The participants were women with vaginismus without any organic pathology in gynecological examination and healthy controls. Twenty-five women with vaginismus and 25 controls who have no difficulty with vaginal penetration were evaluated by self-reported scales for depression, anxiety and sexual function. Sociodemographic variables were collected for each participants. Results: Women with vaginismus did not differ from controls in sociodemographic characteristics. The women with vaginismus had significantly higher levels of depression and anxiety. Total score of Glombok-Rust Sexual Satisfaction Scale, subscores of vaginismus, satisfaction, avoidance, anorgasmia were significantly higher and level of sexual knowledge was also limited in women with vaginismus. Discussion: Multiple sociodemographic and clinical factors are found associated with vaginismus. Some of the findings are supported by the literature but some are not. This may remind us there are still unclear concerning related factors in vaginismus. So, there is need for further studies in which hypotheses of different etiopathogeneses of vaginismus will be held.