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Journal of clinical psychopharmacology 08/2012; 32(5):723-4. · 5.09 Impact Factor
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ABSTRACT: INTRODUCTION: Schizophrenia is associated with a significant risk of suicide, and suicide still remains one of the main causes of death in schizophrenic patients. Beside classic risk factors for suicidality, temperament and character traits have been researched and considered as risk factors for suicidal behavior in recent years. METHOD: Subjects were 94 patients with schizophrenia who were under treatment. All patients were in a stable phase of the illness. Patients with lifetime suicide attempt (n = 46) and without suicidal attempt (n = 48) were compared with each other in terms of temperament and character traits by using the Temperament and Character Inventory. RESULTS: Harm avoidance and persistence scores were higher in suicidal schizophrenic patients compared with nonsuicidal schizophrenic patients. The scores of self-directedness and cooperativeness were lower in suicidal schizophrenic patients compared with nonsuicidal schizophrenic patients. These 4 variables remained significant predictors of lifetime suicidal attempts in a logistic regression model. CONCLUSION: To the best of our knowledge, the present study is the first that specifically compares schizophrenic patients with and without suicidal behavior by the Cloninger temperament and character model. Our data indicate that schizophrenic patients will show a greater risk for suicide according to certain personality configurations. However, to establish causal relationships between personality and suicidality in schizophrenia, longitudinal studies are warranted within a multifactorial interactive framework of biologic and clinical variables.
Comprehensive psychiatry 06/2012; · 2.08 Impact Factor
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ABSTRACT: The purpose of this study was to examine personality traits of patients with major depressive disorder and explore the possible connections between personality and clinical and sociodemographic variables.
The sociodemographic and clinical properties of 80 patients with major depression, who were euthymic according to Hamilton Depression Scale scores, were recorded. Their personality was evaluated by using Temperament and Character Inventory and results were compared with 80 age- and sex-matched healthy controls. We used general linear model analysis to evaluate the manner in which the variables contributed to TCI scores.
Remitted depressive patients scored significantly lower on on self-directedness and higher on harm avoidance than HC. Previous suicide attempts had a main effect only on harm avoidance while previous psychotic mood episodes were significantly associated with novelty seeking, self-directedness and cooperativeness. With respect to numeric clinical variables, only duration of illness was significantly and negatively correlated with NS and RD scores.
Patients with euthymic major depressive disorder may have significantly different personality traits than the normal population, and patients with different clinical and sociodemographic characteristics may show different personality patterns. In addition, assessment of major depressed patients by means of the Temperament and Character Inventory may be helpful to get a deeper insight into those personality traits underlying suicidality and the emergence of psychotic mood episode.
Psychiatry investigation 06/2012; 9(2):119-26. · 0.99 Impact Factor
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ABSTRACT: Background: Violence is a significant clinical and public concern and is a frequent occurrence in patients with schizophrenia. The relationship between insight and violence remains controversial. In addition, there is a lack of research on insight, cognitive insight, demographic and psychopathologic variables in violent versus nonviolent schizophrenia patients. Aim: We aimed to compare insight, cognitive insight, psychopathological and demographic variables in violent and nonviolent subjects suffering from schizophrenia. In addition, we aimed to determine the demographic and clinical predictors of violent behaviour in patients with schizophrenia. Method: We recruited 133 schizophrenic patients without concomitant substance abuse or axis II disorder. Diagnoses were based on the SCID-I and SCID-II. Violent behaviours were assessed using the Overt Aggression Scale. Insight and cognitive insight were assessed with the Scale to Assess Unawareness of Mental Disorder and the Beck Cognitive Insight Scale, respectively. Results: We compared 47 patients with violent schizophrenia with 86 nonviolent patients. Non-violent patients had more severe depression, lower scores on positive symptoms, better clinical insight, more self-reflectivity and higher R-C index scores than did violent patients. In addition, history of violence, lower self-reflectiveness, worse clinical insight and delusion severity were significant predictors of violence in schizophrenia. Conclusion: The present study suggests that the inclusion of insight and cognitive insight may increase the prediction of violence in this population. In addition, clinicians should consider using non-pharmacological techniques that are based on cognitive behaviour therapy and enhance insight, particularly cognitive insight, among patients with schizophrenia who exhibit violent behaviour.
Nordic journal of psychiatry 05/2012; · 0.99 Impact Factor
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ABSTRACT: Patients with deficit schizophrenia have worse cognition and poorer social functioning compared with those with nondeficit schizophrenia. Insight is another domain in which these two groups might differ. However, there is no literature data specifically on cognitive insight impairment in deficit versus nondeficit schizophrenia. We compared 40 patients with deficit schizophrenia with 81 nondeficit patients and found that schizophrenic patients with deficit syndrome were more self-reflective and have higher self-reflectiveness-self-certainty index scores than did those without deficit syndrome. These differences remained significant when analysis was controlled for sex, age, education, and depression severity. On the other hand, there was no significant difference in self-certainty scores between two groups. In addition, we found significant relationships between cognitive insight and specific psychotic symptoms. A better understanding of the cognitive component of insight in schizophrenia with deficit syndrome may help us to understand the true relationship between insight and negative symptoms and contribute to the development of more efficient cognitive strategies, thus improving patients' outcome in a severely disabled psychiatric patient group.
The Journal of nervous and mental disease 01/2012; 200(1):44-50. · 1.77 Impact Factor
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ABSTRACT: The purpose of this study was to examine trait impulsivity in patients with bipolar disorder and explore the possible connections between impulsivity and clinical presentation of the illness. Diagnoses were based on the Structured Clinical Interview for DSM-IV. The sociodemographic and clinical properties of 71 patients with bipolar disorder, who were euthymic according to Young Mania Rating Scale and Hamilton Depression Scale scores, were recorded. Their trait impulsivity was evaluated by using the Barratt Impulsiveness Scale (BIS) and impulsivity subscale of the Temperament and Character Inventory, and the results were compared with 50 age- and sex-matched healthy controls and among patients with different clinical properties. All BIS-11 subscale scores were higher in bipolar than in comparison subjects. There were no effects of education and age. Elevated BIS-11 scores were associated with predominant depressive polarity, longer duration of illness and a history of psychotic mood episodes and suicide attempts. These relationships persisted when age, gender, and education were taken into account. These results show that after accounting for common confounding factors, trait-like impulsivity was substantially higher in subjects with bipolar disorder than in nonbipolar comparison subjects and may vary according to different clinical presentations.
Psychiatry Research 07/2011; 190(2-3):259-64. · 2.52 Impact Factor
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ABSTRACT: The purpose of this study was to examine the trait impulsivity of patients with a major depressive disorder and to explore the possible connections between impulsivity and clinical and sociodemographic variables. The sociodemographic and clinical properties of 60 patients with major depression, who were euthymic according to Hamilton Depression Scale scores, were recorded. Their trait impulsivity was evaluated using the Barratt Impulsiveness Scale (BIS-11) and the impulsivity subscale of the Temperament and Character Inventory, and the results were compared with those of 50 age- and sex-matched healthy controls. We used general linear model analysis to evaluate the manner in which the variables contributed to BIS-11 scores. Some impulsivity scores were higher in those with a major depressive disorder than in comparison subjects. There were significant effects of education and sex in these differences. Elevated BIS-11 scores were associated with a history of psychotic mood episode and suicide attempts. These relationships persisted when age, sex, and education were taken into account. These results show that, after accounting for common confounding factors, trait-like impulsivity was substantially higher in subjects with major depressive disorder than in comparison subjects and may be associated with sociodemographic and clinical properties.
The Journal of nervous and mental disease 07/2011; 199(7):454-8. · 1.77 Impact Factor
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ABSTRACT: Despite comorbid depression being relatively common even in subjects with schizophrenia, to the best of our knowledge, there is, to date, no report in the literature specifically and detailed examining the cognitive and clinical insight in subjects with schizophrenia and a comorbid depressive syndrome. Hence, in this study, we sought to compare the cognitive and clinical insight in our subjects with schizophrenia with and without a comorbid depressive syndrome. We found that participants in the depressive group scored significantly higher on self-reflectiveness and the reflectiveness-certainty (R-C) index scores than those in the nondepressive group. There was no significant difference among groups on the Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, and clinical insight scores assessed by the Scale to Assess Unawareness of Mental Disorder. In addition, self-reflectiveness scores significantly correlated with depression, observed depression, hopelessness, and suicidality subscores of the Calgary Depression Scale for Schizophrenia. A better understanding of the cognitive component of insight in schizophrenia with comorbid depression may contribute to develop more efficient cognitive strategies, thus improving patient outcome. However, clinicians should be aware of the possibility of exacerbating a sense of hopelessness and suicide risk during the interventions that improve cognitive insight.
Comprehensive psychiatry 04/2011; 53(2):195-200. · 2.08 Impact Factor
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Acta neurologica Belgica 03/2011; 111(1):62-5. · 0.54 Impact Factor
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Journal of clinical psychopharmacology 02/2011; 31(1):134-5. · 5.09 Impact Factor
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ABSTRACT: Hyperprolactinemia, an adverse side-effect of the use of typical and some atypical antipsychotics, has both acute and chronic clinical consequences. When observed in schizophrenic patients, it may be treated by switching the patient to an antipsychotic agent with a lower liability for the induction of hyperprolactinemia. The effects of substituting aripiprazole for other antipsychotic agents on schizophrenic patients with antipsychotic-induced hyperprolactinemia have been previously reported in several studies. Many studies have also noted that aripiprazole can sometimes lead to increases in psychotic symptoms, especially in the period immediately following the switch or when aripiprazole is combined with a dopamine antagonist. Here, we report observations on five female patients who were experiencing symptomatic hyperprolactinemia and psychotic exacerbation while on antipsychotic treatment, yet improved in both conditions after being switched to aripiprazole monotherapy. We also provide a brief review of the existing studies that report the results of switching patients from other antipsychotics to aripiprazole.
Archives of Women s Mental Health 02/2010; 13(5):443-7. · 2.06 Impact Factor
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The Primary Care Companion to The Journal of Clinical Psychiatry 01/2010; 12(6).
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Progress in Neuro-Psychopharmacology and Biological Psychiatry 11/2009; 34(2):412-3. · 3.25 Impact Factor
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Progress in Neuro-Psychopharmacology and Biological Psychiatry 10/2009; 33(8):1557-8. · 3.25 Impact Factor
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Progress in Neuro-Psychopharmacology and Biological Psychiatry 05/2009; 33(3):571-2. · 3.25 Impact Factor
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Progress in Neuro-Psychopharmacology and Biological Psychiatry 08/2008; 32(5):1353-4. · 3.25 Impact Factor
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Progress in Neuro-Psychopharmacology and Biological Psychiatry 08/2008; 32(5):1349-50. · 3.25 Impact Factor
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Progress in Neuro-Psychopharmacology and Biological Psychiatry 06/2008; 32(6):1613-4. · 3.25 Impact Factor
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ABSTRACT: Duloxetine is a serotonin-norepinephrine reuptake inhibitor which is generally safe and well tolerated. Antidepressants especially selective serotonin reuptake inhibitors (SSRIs) were associated with inducing bruxism; however, duloxetine-induced bruxism has not been reported yet. Here, we report a case of duloxetine-induced bruxism in a patient with generalized anxiety disorder.
Clinical neuropharmacology 34(4):137-8. · 2.35 Impact Factor
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Omer Gecici,
Murat Kuloglu,
Ozkan Guler,
Omer Ozbulut,
Erhan Kurt,
Sinay Onen, Okan Ekinci,
Dilek Yesilbas,
Ali Caykoylu,
Murat Emül,
Gazi Alatas,
Yakup Albayrak
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ABSTRACT: ZET: Şizofreni hastalarında sanrı ve varsanıların feno-menolojisi Giriş: Bu çalışmada şizofreni hastalarından oluşan 2 ayrı grup üzerinde şizofrenide rastlanan sanrı ve varsanıların fenomenolojisi üzerine farklı coğrafik bölgelerde yaşama-nın etkilerinin araştırılması amaçlanmıştır. Metod: Hasta grubu, Türkiye'nin 3 ayrı psikiyatri hastane-sinde yatarak tedavi edilen toplam 373 kişiden oluşmak-tadır. Bu hastaların sanrıları Huber ve Gross tarafindan geliştirilen sınıflama sistemi kullanılarak değerlendirildi. Hastalar yaşadıkları bölgeler göz önüne alınarak kategorize edildi. 1. Grup Türkiye'nin Batı Bölgesini (Marmara Bölgesi), 2. Grup ise Türkiye'nin Orta Bölgesi'ni (İç Anadolu ve İç Ege Bölgesi) temsil etmektedir. Sonuçlar: Her iki cinsiyet ve grupta en sık olarak referans ve perseküsyon sanrıları saptanmıştır. Zehirlenme ve eroto-manik sanrı kadınlarda erkeklerden daha sık görülmüştür. En yaygın işitsel varsanıları dinsel inançla ilgili ve telkinde bulunan sesleri içermektedir. Cinleri görmek en yaygın görsel halüsinasyon temalarındandır. Tartışma: Sonuçlar, bir ülkede ikamet edilen coğrafi bölge ile sanrı ve varsanıların içeriği arasında bir ilişkiye işaret etmektedir. Her ne kadar kültürel ve çevresel faktörler, sanrı ve varsanıların fenomenolojisinde önemli ise de; yaşanılan coğrafik bölge de bu bağlamda büyük bir önem arzetmektedir. Anah tar söz cük ler: Şizofreni, sanrı, varsanı, fenomenoloji Kli nik Psi ko far ma ko lo ji Bül te ni 2010;20:204-212 ABS TRACT: Phenomenology of delusions and hallucinations in patients with schizophrenia Background: The aim of this study is to investigate the influence of living in different geographic regions of the same country on the phenomenology of schizophrenic delusions and hallucinations in two groups of schizophrenic patients. Methods: A total of 373 schizophrenic patients hospitalized in three different psychiatric hospitals in Turkey were recruited, and their delusions were classified by using the classification system developed by Huber and Gross. Patients were categorized with respect to regions in which they lived. Group 1 represented the Western region of Turkey, and group 2 represented the Central region of Turkey. Results: Delusions of persecution and reference were detected frequently in both genders and groups. Delusions of poisoning and erotomania were more prevalent in females than in males. The most frequent auditory hallucinations included hearing voices conversing and voices commenting. Seeing goblins was the most prevalent theme in visual hallucinations. Conclusions: The results demonstrate a relationship between the content of delusions and hallucinations and living in different geographic regions of the same country. Although cultural and environmental factors are important in the phenomenology of delusions and hallucinations, the geographic region of residence seems to be great importance in phenomenology as well.
