People with schizophrenia are amongst the most stigmatized of those with mental illnesses. The purpose of this study was to examine whether an antistigma program which consists of education, contact, ...and viewing a film that depicts an individual with schizophrenia, can change attitudes towards people with schizophrenia. The antistigma program was carried out with first-year medical students (n = 25). Students' attitudes towards people with schizophrenia were assessed before and after the program. In parallel, a control group of first-year medical students were questioned (n = 35). Assessment was repeated after 1 month. Favorable attitudinal changes were observed in terms of 'belief about the etiology of schizophrenia', 'social distance to people with schizophrenia', and 'care and management of people with schizophrenia'. In contrast, no significant change was observed in the control group. Attitude changes tended to decrease at the 1-month follow up. These results suggest that attitudes towards schizophrenia could be changed favorably with this program. To sustain changed attitudes towards people with schizophrenia, antistigma programs should be offered on a regular basis.
Objective. The purpose of this study was to present the frequencies of personality disorders in a sample of bipolar I patients and to investigate whether the presence of comorbid personality ...disorders affect the course of bipolar illness. Methods: Seventy euthymic bipolar I patients were assessed using the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID II). Bipolar patients with comorbid personality disorder were compared with those of without personality disorder comorbidity on demographic and clinical variables. Results: Forty bipolar I patients (57%) had at least one comorbid personality disorder. The most common personality disorder cluster was cluster C (36%), followed by cluster B (17%) and cluster A (17%) personality disorders. The most prevalent personality disorder in the whole group was obsessive-compulsive personality disorder (21%). Patients with comorbid personality disorders had an earlier age of onset than those of without comorbidity. Conclusion: Although the rates of comorbid personality disorders are high in bipolar I patients, the presence of comorbidity has no relevant impact on the course of bipolar I patients except for earlier age of onset of bipolar I disorder.
Amac: Kesitsel calismada Psikotik Bozukluklar Birimi'mizde takip edilen sizofreni hastalarinda metabolik sendrom (MetS) sikligini saptamak ve MetS sikligi ile hastalarin kullandiklari ilaclar ...arasindaki iliskiyi incelemek amaclanmistir. Yontem: Calismaya dahil edilen 87 sizofreni hastasinin aclik kan sekeri (AKS), yuksek dansiteli lipoprotein (High Density Lipoprotein, HDL) ve trigliserid (TG) degerleri ve o siradaki arteriyel kan basinclari, bel cevresi, boy ve kilolari degerlendirildi. Bulgular: MetS sikligi, Yetiskin Tedavi Paneli III (Adult Treatment Panel III, ATP III) tani olcutlerine gore %29.9, ATP III A'ya gore %35.6 ve Uluslararasi Diyabet Federasyonu (International Diabetes Federation, IDF) tani olcutlerine gore ise %42.5 olarak tespit edilmistir. Hastalarin %27.6' sinda MetS olcutlerinden ikisi pozitifti ancak MetS tanisini karsilamiyordu. MetS ile yas, hastaligin baslangic yasi ve hastalik suresi arasinda iliski yoktu. Tum tani olcutlerine gore erkeklerde MetS daha sikti ancak bu sadece IDF'ye gore istatistiksel olarak anlamliydi. Tekli ve coklu antipsikotik tedavisi alan hastalar arasinda MetS sikligi acisindan anlamli fark saptanmadi. Biperiden kullanan hastalarda MetS sikligi anlamli olarak kullanmayanlara gore daha dusuktu. Sonuc: Calismamizda MetS sikligi bazi calismalara gore dusuk oranlarda olsa da genel olarak sizofrenide bildirilmis oranlara benzerlik gostermektedir. Sizofreni hastalarinin takiplerinde ve tedavi seceneklerinde MetS ciddiyetle goz onune alinmalidir, gerekli durumlarda erken donemde risk azaltici mudahaleler yapilmalidir. Anahtar kelimeler: Sizofreni, metabolik sendrom, antipsikotikler Objective: In this cross-sectional study we aimed to determine the metabolic syndrome (MetS) prevalence in schizophrenia patients followed up in our Psychotic Disorders Unit, and to evaluate the relationship between MetS and medication of the patients. Method: High density lipoprotein (HDL), fasting glucose, triglyceride levels, arterial blood pressure and waist circumference at the level of the umbilicus of the patients included in the study were measured in 87 schizophrenia patients. Results: According to Adult Treatment Panel III (ATP III). ATP III A and International Diabetes Federation (IDF) criteria; metabolic syndrome prevalence was 29.9%, 35.6% and 42.5% respectively. 27.6% of patients had two criteria of MetS but did not meet MetS diagnosis. There was no association between MetS and age, age of onset of illness and duration of illness. Men had higher MetS prevalence according to all diagnostic criteria, however there was a statistical significance only for IDF. There was no difference of MetS prevalence between monotherapy and combined antipsychotic medications. The metabolic syndrome prevalence was significantly lower in biperiden users than in the nonuser patients Discussion: Although the prevalence of MetS is lower than in some previous studies, it is generally similar to other schizophrenia researches. MetS must be carefully considered in schizophrenia patients follow up and treatment choices, and some risk decreasing interventions must be made when necessary in the early period. Keywords: Schizophrenia, metabolic syndrome, antipsychotics
Amaç: Elektrokonvülzif tedavinin (EKT) oksidatif metabolizma üzerine etkileri ile ilgili literatürün çoğu hayvan deneylerine dayanmaktadır ve oksidan/antioksidan dengenin değiştiğine dair çelişkili ...sonuçlar içermektedir. Bu alanda yapılan ilk insan çalışması olan bu çalışmanın amacı depresif hastalarda EKT sonrası oksidan ve antioksidanlardaki değişimleri araştırmaktır.
Yöntemler: On dört unipolar ve iki bipolar depresyon hastası çalışmaya dahil edildi. Kan örnekleri ilk EKT seansından 1 saat once ve 7. EKT seansından 1 saat sonra alındı. Plazmada oksidanlardan malondialdehit (MDA), nitrik oksit (NO) ve ksantin oksidaz (XO); antioksidanlardan süperoksit dismutaz (SOD) seviyeleri ölçüldü.
Bulgular: Birinci ve 7. EKT seansından sonraki Hamilton Depresyon Ölçeği (HAM-D) skorları 32.63±9.54 ve 16.50±7.22 idi (t=7.92, df=15, p<0.001). Yedinci EKT sonrası SOD değerleri EKT öncesi SOD değerlerinden anlamlı olarak düşüktü (p<0.05, Z= -3,459). EKT öncesi ve sonrası MDA, NO ve XO değerleri arasında anlamlı bir farklılık yoktu (p>0.05). Bununla birlikte, EKT öncesi SOD değerleri EKT öncesi HAM-D skorları ile anlamlı düzeyde pozitif korelasyon gösteriyordu (r=0.641, p=0.007).
Sonuç: EKT sonrası antioksidan bir enzim olan SOD düzeyindeki düşüş oksidatif stresi arttırarak nöronlara zarar verebilir. Bu nedenle EKT uygulama dönemlerinde antioksidan ekleme tedavilerinin olası faydaları araştırılmalıdır. Yine EKT öncesi yüksek oksidan seviyeleri depresyon hastalarında EKT'ye kötü yanıtı yordayabilir.
Objective: The literature regarding effects of electroconvulsive therapy (ECT) on oxidative metabolism (OM) reports conflicting changes in oxidant and antioxidant status in animal studies. The goal of this first human study was to investigate the changes in oxidants and antioxidants in plasma of depressed patients after ECT.
Methods: Fourteen unipolar and two bipolar patients were included in the study. The blood samples were obtained within one hour before the 1st and within one hour after the 7th ECT sessions. Oxidants malondialdehyde (MDA), nitric oxide (NO), and xanthine oxidase (XO) and antioxidant superoxide dismutase (SOD) were measured in the plasma.
Results: Before the 1st and after the 7th ECT sessions, the Hamilton Depression Rating Scale (HDRS) scores were 32.63±9.54 and 16.50±7.22, respectively (t=7.92, df=15, p<0.001). After the 7th ECT, SOD values were significantly lower than pre-ECT SOD values (p<0.05, Z= -3,459). There were no significant difference between pre-and post-ECT values of MDA, NO, and XO (p>0.05). However, pre-ECT SOD values were significantly and positively correlated with pre-ECT HDRS scores (r=0.641, p=0.007).
Conclusion: The decrease in antioxidant enzyme SOD after ECT may damage the neurons by increasing oxidative stress. Thus, possible benefits of antioxidant supplementation during ECT should be investigated. Additionally, higher pre-ECT oxidant levels may predict a poor response to ECT in depression.
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