According to preoperative anesthesia consultations of the patients, 62.1% (n=36) were assessed to be in ASA 2 risk group and 34.5% (n=20) in ASA 3 risk group. Yaşlılık, elektrokonvülzif tedavi, ...güvenilirlik INTRODUCTION Electroconvulsive therapy is a somatic treatment method that is widely used throughout the world for various psychiatric disorders that are severe and resistant to treatment.1 Studies show that ECT is used in various populations and indications, and it is one of the most effective treatment methods that provide the fastest response in the treatment of depression, bipolar disorder and psychosis in geriatric patients. 2'3 ECT is a saving in some life-threatening conditions such as catatonia, neuroleptic malign syndrome, intense suicidal thoughts, refusal to eat and uncontrollable mania.4-6 It is observed that drug tolerance in the geriatric population is low due to age-related pharmacokinetic changes, and increased sensitivity to drug side effects such as anticholinergic effects and orthostatic hypotension. ...ECT is an advantageous treatment option in geriatric patients especially from the aspect of toxic presentations and drug interaction potential due to multiple drug use and comorbid diseases.7 In some studies conducted on patients with late onset geriatric depression and coexisting cerebral small vessel disease, it was shown that the efficacy of medical treatment was lower.8 It was demonstrated that response to ECT was better in geriatric patients who more frequently have neuropsychiatric comorbidities as compared to younger patients.9'10 Although it is very well known that ECT is an effective and reliable treatment option, it is a less preferred treatment option in geriatric patients in many places throughout the world. According to ASA risk classification, mortality rate in ASA 2 risk group and ASA 3 risk group patients is 0.27-0.4% and 1.8-4.3%, respectively.23'24 Our data show that complication rate was higher in ASA 3 patients than ASA 2 patients as expected (p=0.040).
Several lines of evidence indicate that circadian rhythm disruption is associated with bipolar disorder (BPD). This strong association, along with evidence from genome wide association studies (GWAS) ...implicating clock and clock controlled genes with BDP and efficacy of lithium treatment, suggests that BPD circadian rhythm disruption may represent a core etiology feature. Lower morning expression of the neuropeptide somatostatin (SST) has been previously reported in the brain and cerebral spinal fluid of subjects with BPD, coinciding with increased morning severity of anxiety and depression. We aimed to test the hypothesis that levels of neuropeptides involved in circadian rhythm regulation, including somatostatin (SST), neuropeptide-Y (NPY), arginine vasopressin (AVP), vasoactive intestinal peptide (VIP) and cortisol levels, are altered in blood samples collected in the morning from patients BPD.
Thirty nine patients diagnosed as BPD according to DSM-5, and 38 healthy controls were enrolled in the study. Blood were collected at 9 AM from all subjects. Serum levels of SST, NPY, AVP, VIP and cortisol were measured.
We observed significantly lower levels of SST (p = 0.001), NPY (p = 0.001), VIP (p = 0.001) and cortisol levels (p = 0.001) in the morning in subjects with BPD compared to control subjects. Significant positive effects of Young Mania Rating Scale and lithium treatment with cortisol, SST, and VIP levels were observed.
Our study suggests that lower morning levels of SST, NPY, VIP and cortisol may represent biomarkers underlying disrupted biological rhythms and behavioral and sleep disturbances observed in patients with BPD.
Psikojenik polidipsi veya kendiliğinden indüklenen su zehirlenmesi, kompulsif su içimini tanımlamak için kullanılır. Mental hastalıklarda nadir görülen bir durum değildir. En sık kronik şizofrenide ...görülür. Tedavisi etiyolojiye ve tablonun ciddiyetine göre düzenlenir. Hafif vakalarda su kısıtlaması ve hastanın eğitimi yeterlidir, ağır olgularda tedavide su kısıtlaması, tuz solüsyonu infüzyonu, diüretikler, hiponatremi kaynaklı nöbetlerin kontrolünün sağlanması için antikonvülsan ilaç uygulaması yapılır. Akut klinik tablonun tedavisinden sonra altta yatan primer psikiyatrik hastalığın tedavisi yeniden düzenlenmelidir. Bu yazıda şizofreni tanısıyla 14 yıldır takip edilen ve psikojenik polidipsi tanısı alan ve amisülpirid tedavisi ve sıvı kısıtlaması ile başarıyla tedavi edilen 39 yaşında bir erkek hasta sunulmuştur.
Psychogenic polydipsia or self-induced water poisoning is used to describe compulsive drinking. It is not a rare condition in mental disorders. Chronic schizophrenia is the most common reason. Treatment should be organized according to the etiology and severity of the case. In mild cases, water restriction and patient education is sufficient, but In severe cases, are recommended water restriction, salt solution infusion, diuretics and application of anticonvulsant drugs to control hyponatremia-induced seizures. The treatment of the underlying primary psychiatric disease should be rearranged after the treatment of the acute clinic symptoms. In this article, we present a 39-year-old male patient with a diagnosis of chronic schizophrenia with psychogenic polydipsia and was treated successfully with amisulpride and fluid restriction.
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: In the present study, we aimed to examine the relationship between the oxidative metabolism with disease severity, sociodemographic, and clinical characteristics in the patients with ...schizophrenia.
Methods: Seventy-one patients with schizophrenia and 76 healthy volunteers were included in the study. Plasma total antioxidant level (TAL) and total oxidant level (TOL) were analyzed, and oxidative stress index (OSI) was calculated.
Results: There was a statistically significant increase in TOL and OSI and decrease in TAL in the patients with schizophrenia compared to the controls (p < .05). There were positive, mild, statistically significant correlations between TOL, OSI, and Positive and Negative Syndrome Scale-Total scores (p = .01, p = .01, respectively), Positive and Negative Syndrome Scale-Negative scores (p = .002, p = .001, respectively), Positive and Negative Syndrome Scale Global Psychopathology scores (p = .03, p = .03, respectively), and Clinical Global Impression-Severity Scale scores (p = .008, p = .009 respectively). OSI levels were significantly lower in the patients who were on treatment with atypical antipsychotics (AAP) compared to the patients who were on typical antipsychotics (TAP) and combined antipsychotic (CAP) agents (p = .032).
Conclusions: Oxidative stress was higher in schizophrenia patients. The increased severity of negative symptoms was in line with the disruption in oxidative balance. Oxidative stress is quite lower in AAP users compared to the TAP and CAP users. One of the mechanisms underlying the fact that AAPs are more effective on negative symptoms than typical agents may be the positive effect on the oxidative stress.
Abstract Diminished pain sensitivity or loss of pain sensation in schizophrenic patients has previously been reported. We report an interesting case of a schizophrenia patient who had the disease for ...20 years and who had his forearm amputated below the elbow level due to severe burn injury to his muscles, tendons, nerve fibers and bone tissue, caused by direct exposure to flames from a liquefied petroleum gas cylinder, in an attempt to make himself warm during a medicine-free period with active symptoms and without pain sensation.
Schizoaffective disorder is a disease with both affective and psychotic symptoms. In this study, we aimed to compare oxidative metabolism markers of schizoaffective disorder, bipolar disorder and ...schizophrenic patients. Furthermore, we also aimed to investigate whether schizoaffective disorder could be differentiated from schizophrenia and bipolar disorder in terms of oxidative metabolism.
Total oxidant status (TOS) and total antioxidant status (TAS) were measured in the blood samples that were collected from schizoaffective patients (n = 30), bipolar disorder patients (n = 30) and schizophrenic patients (n = 30). Oxidative stress index (OSI) was calculated by dividing TOS by TAS.
TOS and OSI were found to be higher in patients with schizoaffective disorder compared with those in schizophrenia and bipolar disorder patients. TAS was not significantly different between the groups.
Schizoaffective disorder was found to be different from bipolar disorder and schizophrenia in terms of oxidative parameters. This result may indicate that schizoaffective disorder could differ from bipolar disorder and schizophrenia in terms of biochemical parameters. Increased TOS levels observed in schizoaffective disorder may suggest poor clinical course and may be an indicator of poor prognosis.
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