[Show abstract][Hide abstract]ABSTRACT: Objectives: Psychopathy is a distinct personality organization and differs from antisocial personality disorders in many aspects. Its diagnosis is challenging but also critical to predict criminality. In this context, Psychopathy Checklist Revised (PCL-R) is a useful tool in the diagnosis of psychopathy. Its reliability and validity was shown in various populations but has not been studied in a Turkish population. Our aim was to demonstrate the reliability and validity of PCL-R in Turkish. Methods: 425 male subjects with antisocial personality disorder and 125 controls without any psychiatric diagnosis were included in the study. DSM-5 diagnostic criteria were used and PCL-R was administered to all participants. The reliability of the Turkish version of PCL-R was determined by test–retest and internal consistency methods. In the ROC analysis performed with PCL-R, DSM-5 criteria were taken as a gold standard, the sensitivity; specificity and cut-off values of PCL-R were estimated. To evaluate the adequacy of the scale construct validity, Exploratory Factor Analysis and Kaiser-Meyer-Olkin (KMO) and Barlett tests were applied. Reproducibility of the test was evaluated by Pearson correlation coefficient. Re-test was performed with 171 subjects two weeks after the first test. Results: In reliability analysis, the Cronbach’s alpha internal consistency coefficient was calculated to be α=0.977. Pearson correlation coefficient of test-retest was r=0.94 (p<.001). Item-total correlations ranged from 0.18 to 0.94. Its sensitivity and specificity was 98.3% and 100.0%, respectively, with a cut-off point of 20. In principal component analysis, two factors had Eigen values greater than 1. These two factors accounted for 76.54% of the variance in PCL-R scores. Conclusions: PCL-R (Turkish) is a valid and reliable measure of psychopathy to detect psychopathic traits. However, more studies on psychopathy need to be conducted in different Turkish sample groups.
Full-text Article · Jul 2015 · Bulletin of Clinical Psychopharmacology
[Show abstract][Hide abstract]ABSTRACT: Background: Leptin has attracted considerable interest in psychiatric disorders. It is expressed in the brain and an interaction between leptinergic and serotonergic systems has been demonstrated. Growing evidence now points to leptin as an important mediator in stress reactions and it has been postulated to modulate synaptic plasticity. Objective: In this study, our aim was to evaluate serum leptin levels in patients with antisocial personality disorder. Methods:The study included 72 patients and 75 controls. The patients met the fourth Diagnostic and Statistical Manual of Mental Disorders IV criteria for antisocial personality disorder. The HARE Psychopathy Checklist was performed and serum leptin was measured. Results: Mean serum leptin levels were significantly lower in patients than in healthy controls. Leptin levels were inversely correlated with the severity of antisocial personality disorder, as rated by the HARE Psychopathy Checklist. Conclusion: Our research points to a possible relationship between antisocial personality disorder and serum leptin levels. Further studies are needed to describe the exact roles of leptin in antisocial personality disorder.
Full-text Article · Mar 2013 · Bulletin of Clinical Psychopharmacology
[Show abstract][Hide abstract]ABSTRACT: Objective: In this study, we aimed to determine whether QT dispersion known to be associated with development of coronary artery disease is related with positive (PA) and negative affect (NA) in healthy young adult men. Method: Two hundred and forty-four healthy males aged between 21-30 years were included in this study. Standard electrocardiographic (12 derivation and 50 mm/sec) and echocardiographic evaluations were performed. The duration of QT dispersion was measured digitally. Patients with sinus bradycardia, sinus tachycardia, bundle branch block, preexcitation and electrolyte imbalances were excluded. PA and NA scores of the subjects were determined by the Positive and Negative Affect Scale and clustered into "high" and "low" affect subtypes. Results: QT dispersion was significantly increased in subjects with high NA compared with those with low NA. There was no difference between the subjects having high PA and low PA. QT dispersion correlated positively with NA but not with PA. Conclusion: The results of this study have shown that there may be a relation between QT dispersion and NA in healthy young adult men.
Article · Jan 2013 · Bulletin of Clinical Psychopharmacology
[Show abstract][Hide abstract]ABSTRACT: However the lifetime prevalence of bipolar disorder is not different between men and women, some of the features of the disease vary between the genders. The aim of this study was to compare the clinical and sociodemographic features of bipolar disorder according to gender. In this study the data of 125 bipolar disorder tip I patients who had been admitted to Department of Psychiatry of Gulhane Military Medical Faculty between 2009-2011 were examined. Data of these patients were obtained by examining the patients files. 95 of 125 patients (%76.0) were male, and 30 (%24.0) were female. Age of disease onset in bipolar male patients was 22,5 ± 6,9; %6.3 had a history of suicid attempt and %11.6 had a history of substance abuse. Age of disease onset in bipolar female patients was 28,7 ± 9.7. %23.3 had a history of suicide attempt. There was no history of substance abuse in female patients. Psychotic features and history of substance abuse were more prominent in men. The later age of disease onset and longer duration of hospitalization were determined in women. Our results were appeared to be in line with the results of the studies about gender differences in bipolar disorder. Making prospective studies about this subject is considered to be useful to determine the epidemiological characteristics of mood disorders.
Full-text Article · Dec 2012 · Gulhane Medical Journal
[Show abstract][Hide abstract]ABSTRACT: Background : Amenorrhea as one of frequent adverse effects associated with the use of atypical antipyschotics is often neglected but can interrupt the compliance of treatment. There are clinical trials regarding improvement of hyperprolactinemia after switching to olanzapine while some trials regarding the opposite and the improvement with aripiprazole. Aripiprazole is an antipsychotic with partial dopamine antagonism and agonism. Its advantageous side effect profile has been described earlier. We reviewed a case in which olanzapine induced amenorrhea normalized without clinical worsening after switching to aripiprazole. Methods : Ms. C, a 36-year-old woman with psychosis, developed menstrual dysfunction and galactorrhea soon after beginning a treatment of olanzapine, 20 mg/day. She reported having monthly menses before regimen. After 3 month of treatment, menses were absent and galactorrhea began. Ms. C was not pregnant. Her prolactin level was 157.20 ng/ml, and an MRI showed no sign of pituitary adenoma. Olanzapine medication was discontinued in the patients because of galactorrhea, and raised liver enzyme activities. Aripiprazole was initiated and titrated to 15 mg/day. Results : After 1 month of aripiprazole treatment, monthly menses resumed and galactorrhea resolved. The serum prolactin fell to a normal level (27.20 ng/ml). Ms. C's psychiatric condition improved and she has remission. Conclusions : Aripiprazole's reduced potential to elevate prolactin may provide a treatment advantage for women with schizophrenia. Moreover, since menstrual cycles may normalize during treatment with aripiprazole, women treated with this drug may have improved fertility when compared with women receiving typical antipsychotics and olanzapine. In this case, aripiprazole treatment resulted in reduction of serum prolactin levels and resolution of galactorrhea. Further studies will be required to assess the comparative effects of aripiprazole and other antipsychotics on prolactin levels and resolution of galactorrhea.
[Show abstract][Hide abstract]ABSTRACT: Neuroleptic Malignant syndrome (NMS) is a rare but potentially fatal adverse effect of antipsychotics. In addition, hypernatremia may play a significant role before occurrence of NMS or it may develop secondary to acute renal failure. Herein we report the case of a 27 year old male patient who developed NMS with hypernatremia and acute renal failure following treatment with olanzapine.
Article · Jul 2012 · Bulletin of Clinical Psychopharmacology
[Show abstract][Hide abstract]ABSTRACT: Nesfatin-1, a recently discovered satiety molecule, is localized in neurons of the hypothalamus and brain stem and colocalized with stress-related substances. However, the relation between nesfatin-1 and stressor related behaviors like anxiety and/or fear has not yet been investigated in human subjects. In the present study, our aim was to investigate whether there was a relationship between plasma nesfatin-1 levels and generalized anxiety disorder. The study group consisted of 40 patients (BMI, 22.98±0.56) with generalized anxiety disorder and 34 age-matched healthy male control subjects (23.05±0.4). Patients fully met the fourth Diagnostic and Statistical Manual of Mental Disorders, text revision. Blood samples for nesfatin-1 were drawn at the end of an overnight fasting period at least 10h. Plasma nesfatin-1 levels were measured and found significantly lower in anxiety disorder group than in control group (0.35±0.037ng/ml vs. 0.63±0.080ng/ml, respectively, p<0.05). Low nesfatin-1 levels may be related with generalized anxiety disorder.
[Show abstract][Hide abstract]ABSTRACT: Background: Prefrontal and/or temporo-limbic abnormalities associated with antisocial personality disorder (APD), high psychopathy scores and violent behaviours can readily be evaluated by neuroimaging methods.
Objectives: In this study, we compared the brain metabolites in adult male military conscripts with APD, high psychopathy scores and serious violent crimes (n = 15) with age- and educational-level-matched healthy controls (n = 15) by means of magnetic resonance spectroscopy.
Methods: All cases were diagnosed by means of the Diagnostic Statistical Manual-IV APD module of the Structured Clinical Interview for DSM III-R Axis II Disorders (SCID-II) semistructured questionnaire in Turkish. The psychopathy scores were evaluated by means of the Hare Psychopathy Checklist-Revised translated into Turkish (PCL-R). PCL-R is a 20-item, reliable and valid instrument for assessment of psychopathy, both in categorical and dimensional natures. All patients had a total score of 29 (of possible 40) or higher from PCL-R, indicating a high degree of psychopathy.
Results: Our results showed no significant differences in ratio of N-acetyl aspartate (NAA), creatine (Cr) and choline-related compounds in the right dorsolateral prefrontal cortex, anterior cingulate cortex (ACC) and amygdala–hippocampus regions of cases compared with controls. ACC NAA/Cr was significantly negatively correlated with both the PCL-R total score and the PCL-R factor I score (interpersonal/affective problems) among the cases.
Conclusion: As ACC plays an important role in decision-making and emotional information processing, we postulate that the lower NAA/Cr ratio, suggesting impaired neural integrity, may increase the severity of interpersonal/affective problems of the psychopathy factor in male subjects exhibiting APD, high psychopathy overall scores and violent crimes.