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Öğe Assessment of psychopathological aspects and psychiatric comorbidities in patients affected by tinnitus(Springer-Verlag, 2008) Belli, Şeyda; Belli, Hasan; Bahçebaşı, Talat; Özçetin, Adnan; Alpay, Emrehan; Ertem, ÜmitThe aim of present study was to determine the psychiatric symptoms and comorbidities in patients affected by tinnitus. The study sample, between June 2004 and September 2005, consisted of 180 Turkish adults living in Elazig. Ninety consecutive tinnitus patients were enrolled on their first visit to the outpatients clinic. Control subjects were recruited partly from the social surroundings of the authors. All subjects with significant medical and/or psychiatric pathologies, such as schizophrenia, manic-depressive psychosis, dementia, and behavioural disorders with social withdrawal or suicidal risk, were excluded, as were those unwilling to take part in the study. For the psychopathological examination, patients underwent the Structured Clinical Interview for DSM-III-R (SCID-I, SCID-II). Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Symptom Check list-90 (Revised) (SCL-90-R) were also administered to patients with tinnitus and control subjects. SCL-90-R subscales scores, Beck Anxiety Inventory and Beck Depression Inventory scores were significantly higher in tinnitus patients than in normal control subjects. Twenty-four patients (26.70%) with tinnitus had at least one psychiatric diagnosis. Five control subjects (5.60%) had at least one psychiatric diagnosis. There were significant differences between the two groups (P < 0.001). Anxiety disorders and somatoform disorders were significantly higher in tinnitus patients than in normal control subjects. We conclude that psychiatric symptoms (such as symptoms of anxiety, depression or somatization) among patients with tinnitus should alert clinicians for the presence of a chronic and complex psychiatric condition (Axis-I and Axis-II disorders).Öğe Çalışan ve çalışmayan kadınların benlik saygılarının karşılaştırılması(2007) Içmeli, Celalettin; Ataoğlu, Ahmet; Canan, Fatih; Gökdoğan, Abdi; Özçetin, AdnanBu araştırma, çalışma yaşamının kadınların benlik saygısını ne ölçüde etkilediğini belirlemek amacıyla planlanmıştır. Bu amaçla, araştırma Düzce il merkezinde çalışan 100 kadın ve çalışmayan (ev hanımı) 100 kadın üzerinde karşılaştırmalı ve tanımlayıcı olarak gerçekleştirilmiştir. Çalışma kapsamına alınan kadınları fiziksel ve psiko-sosyal yönden değerlendirmek üzere, bir görüşme formu ve benlik saygılarını ölçmek için Coopersmith Benlik Saygısı Envanteri kullanılmıştır. Uygulama sonunda elde edilen veriler yüzdelik (%), ki-kare, kolmogorov-simimov testi ve t testi kullanılarak istatistiksel yönden değerlendirilmiştir. Çalışan kadınların çoğunluğunu, üniversite ya da lise mezunu, çekirdek ailede yetişen, anne ve babasının okur-yazarlık düzeyi yüksek olan, yükseköğrenim görmüş eşlerle evli ve genelde iki çocuk sahibi olan, ailede birlikte karar verme eğiliminde ve çalışmaktan memnun olan kadınlar oluşturmuştur. Sonuçta, çalışan kadınların Benlik Saygısı puan ortalamalarının (75.68 ± 14.35), çalışmayan kadınların ki ne (68.32 ± 15.68) göre istatistiksel olarak anlamlı olacak şekilde yüksek olduğu tespit edilmiştir (p< 0.001). Bu sonuca göre, kadınlara her alanda erkeklerle eşit eğitim ve iş olanaklarının tanınması, iş ve aile yaşamında destek sağlanması önerilmiştir.Öğe Effects of depression and anxiety on quality of life patients with rheumatoid arthritis, knee oesteoarthritis and fibromyalgia syndrome(2007) Özçetin, Adnan; Ataoğlu, Safinaz; Kocer E.; Yazıcı, Selma; Yıldız, O.Objective: To measure the effects of depression and anxiety on quality of life (QoL) in patients with rheumatoid arthritis (RA), knee osteoarthritis (OA) and fibromyalgia syndrome (FMS). Methods: One hundred and fifty-four patients with RA, knee OA, and FMS who presented to the physical medicine and rehabilitation department were studied. For evaluation of the patients, Beck depression scale, Beck anxiety scale, and Short Form-36 were used. Results: Twenty-two per cent of patients (n = 34) were diagnosed with of RA, 52.6% (n = 81) knee OA and 25.3% (n = 39) FMS. Except for the subscales, of physical and emotional role, there were statistically significant differences among diagnostic groups in the rest of the SF-36 subscales. In the physical functioning subscale, the highest score was obtained in the fibromyalgia group and the lowest in the RA group (p <0.001). However, in the bodily pain subscale, the lowest score was recorded in the fibromyalgia group (p = 0.019). In all diagnostic groups, the scores of SF-36 subscales were significantly low in patients who scored above the threshold value of Beck depression scale (p < 0.001). A strong negative correlation was detected between scores of Beck anxiety scale and the scores of all SF-36 subscales in patients with RA and knee OA. On the other hand, inpatients with FMS, anxiety scores correlated negatively with only physical and somatic function scores of SF-36. Conclusion: Quality of life is significantly low in patients with RA, knee OA and FMS, whose depression andl/or anxiety scores are high. Therefore, these patients should be managed using a multi-disciplinary approach including psychiatric support.Öğe Evaluation of dexamethasone suppression test in fibromyalgia patients with or without depression(E M H Swiss Medical Publishers Ltd, 2003) Ataoğlu, Safinaz; Özçetin, Adnan; Yıldız, Özcan; Ataoğlu, AhmetObjective: While in most healthy persons dexamethasone administration suppresses cortisol synthesis from the adrenal cortex, such suppression is not usually observed in patients with depression. We set out to investigate whether the dexamethasone suppression test (DST) reveals any neurobiological relationship between fibromyalgia (FM) and depression related to the hypothalamic-pituitary-adrenal (HPA) axis. Method. To discover a relationship between depression and FM we performed the DST in 2 0 FM patients with depression, 26 FM patients without depression and 20 healthy subjects serving as a control group. Results: Compared with the control group the cortisol level was found to be significantly higher in response to the DST in FM patients with depression (p = 0.03; z: -2.165), but not in those without depression (p = 0.15 3 ; z: -1.429). The cortisol level was not found to be statistically significant when patients with FM without depression were compared with the control group (p = 0.249 z: -1.152). In 7 FM patients with depression the DST failed to suppress cortisol; this was statistically significant compared with FM patients without depression (p = 0.014) and the control group (p = 0.008). Among FM patients without depression cortisol was not suppressed in one case. Cortisol was suppressed in all the controls. There was no statistically significant difference in cortisol suppression between FM patients without depression and the control group (p = 1.00). Conclusion: Our findings show that the DST reveals no neurobiological relationship between FM and depression related to the HPA axis.Öğe Low-dose venlafaxine-associated liver toxicity in chronic hepatitis(Harvey Whitney Books Co, 2004) Şencan, İrfan; Şahin, İdris; Özçetin, AdnanVenlafaxine is metabolized in the liver by the isoenzyme CYP2D6. Venlafaxine-associated adverse effects have been reported, such as gastrointestinal and autonomic effects. With the usage of high dosages of venlafaxine,1 adverse effects such as toxic hepatitis have been reported,2,3 but toxic hepatitis has not been reported at low doses of venlafaxine such as 37.5 mg/day. We report a case of probable toxic hepatitis associated with a low dose of venlafaxine in a patient with a history of chronic hepatitis.Öğe Lower doses venlafaxine-associated toxic hepatitis in a patient with chronic hepatitis(2003) Şencan, İrfan; Şahin, İdris; Özçetin, AdnanToxic hepatitis is observed with high doses of Venlafaxine. But toxic hepatitis has not been yet reported at tower doses of Venlafaxine such as 37.5 mg per day. In this case report, a case of Venlafaxine-associated toxic hepatitis with tower doses in patient with history of chronic hepatitis is presented. We suggest that liver function should be regularly monitored in patients with history of chronic hepatitis receiving Ventafaxine even at tower doses and even when their liver enzymes are normal.Öğe Paradoxical therapy in conversion reaction(Korean Acad Medical Sciences, 2003) Ataoğlu, Ahmet; Özçetin, Adnan; İçmeli, Celalettin; Özbulut, ÖmerParadoxical therapy consists of suggesting that the patient intentionally engages in the unwanted behaviour such as performing compulsive ritual or wanting a conversion attack. In this study, the subjects were selected by the emergency unit psychiatrist from patients who were admitted to the emergency unit with pseudoseizure. The diagnoses was based on DSIVI-IV criteria. Paradoxical intention was applied to half of the 30 patients with conversion disorders; the other half were treated with diazepam in order to examine the efficiency of the paradoxical intention versus diazepam. In both groups the differences of the anxiety scores at the beginning of the study were found to be insignificant (z=1.08, p=0.28). Of the 15 patients who completed paradoxical intention treatment, 14 (93.3%) responded favorably to paradoxical intention. On the other hand of 15 patients who completed diazepam therapy, 9 (60%) responded well to therapy and 6 patients carried on their conversion symptoms at the end of 6 weeks. Paradoxical intention-treated patients appeared to have greater improvements in anxiety scores (z=2.43, p<0.015) and conversion symptoms (t=2.27, p=0.034) than the diazepam-treated patients. The results of the present study are encouraging in that paradoxical intention can be effective in the treatment of conversion disorder.Öğe Şizofreni hastalarında bazı sosyodemografik özellikler ve tedavi ile ilişkili etkenler(2007) Belli, Hasan; Özçetin, Adnan; Ertem, Ümit; Alpay, Emrehan; Bahçebaşı, Talat; Kıran, Ümit Kemal; Baykız, Ali FuatAmaç: Ülkemizin daha az gelişmiş ve geniş aile sisteminin yaygın olarak yaşandığı Doğu ve Güneydoğu Anadolu bölgesinde yaşayan şizofreni hastalarını ele aldığımız çalışmamızın amaçları; şizofreni alt tiplerine göre hastaların sosyodemografik ve hastalığın klinik özelliklerini tanılamak, tedavide ilaç seçimi ve tedavi sürecini etkileyen etkenleri ve şizofreni hastalarında madde kullanım örüntüsünü belirlemektir. Yöntem: Çalışmaya Elazığ Ruh Sağlığı ve Hastalıkları Hastanesi'ne aileleriyle birlikte ayaktan başvuran ve yatırılarak tedavi edilmesine karar verilen, DSM-IV tanı ölçütlerine göre şizofreni tanısı konan 15-65 yaş arasında 329 erkek, 134 kadın olmak üzere toplam 463 hasta alındı. Bulgular: Hastalarımızın %87.5'i çalışmıyor, %26.3'ü okuryazar değil, %36.7'si ilkokul mezunuydu. Tüm hastaların %84.7'si alt gelir düzeyinde ve %60.3'ü bekardı. Hastalarımızın %62.4'ü paranoid, %22.7'si dezorganize, %8.2'si rezidüel ve %6.7'si farklılaşmamış şizofreni alt tip ölçütlerini karşılamaktaydı. Hastaların %17.1'i herhangi bir madde kullanmazken, %76.0'sı sigara kalan diğer hastalar ise sigara"ile birlikte alkol ve/veya esrar kullanmaktaydı. Tedavi başlarken ilk tercih edilen ilaç %95.9 ile tipik antipsikotikler olup son kullanılan ilaç seçiminde bu oran %76.3'e düşmekteydi. Tartışma: Hasta grubumuzda tipik antipsikotiklerin birinci tercih olması sürmektedir. Düzenli ilaç kullanımı hastanın hastaneye yatış sayısı ile güçlü pozitif; yaş, ailesiyle birlikte yaşama, tedavi süresi ve evli olma ile zayıf pozitif ilişkili görünüyordu. Hastanın hastane ya da hekimle sürekli iletişim içinde olması ve yakınlarından aldığı sosyal destek tedaviye olumlu katkı sağlamaktadır. Madde kullanımı, meslek, düşük ekonomik düzey, kullanılan ilk ilaç arasında görülen negatif ilişki düzenli ilaç kullanımını engellemekte gibi görünmektedir. Aile ve yakın çevrenin hastaya verdiği sosyal destek ve yine kültürümüzün önemli bir özelliği olan madde kullanımını engelleyici yönünü kullanarak tedaviye uyumu artırabiliriz. Kısıtlı ekonomik olanaklarımızı yan etkisi daha az ve negatif belirtilere daha etkili atipik antipsikotikleri kullanma oranını artırma yönünde kullanarak hastaların yaşam kalitelerini de yükseltip üretkenliklerini artırabiliriz.Öğe T102c polymorphism of serotonin-2a receptor gene in schizophrenia: association with cognitive impairment and soft neurological signs(Elsevier Science Bv, 2012) Poyraz, Burç Çağrı; Özçetin, Adnan; Poyraz, Cana Aksoy; Bozhüyük, Erol; Bolat, Nurullah
