Objectives:To identify clinical predictors of suicide attempts in patients with bipolar disorder.Methods:This study included bipolar patients who were treated in the Psychiatry Department, Haseki Training and Research Hospital, Istanbul, Turkey, between 2013 and 2014; an informed consent was obtained from the participants. Two hundred and eighteen bipolar patients were assessed by using the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) Axis-I (SCID-I) in order to detect all possible psychiatric comorbid diagnoses. Clinical predictors of suicide attempts were examined in attempters and non-attempters. The study design was retrospective.Results:The lifetime suicide attempt rate for the entire sample was 19.2%. Suicide attempters with bipolar disorder had more lifetime comorbidity of eating disorder. Female gender and family history of mood disorder were significant predictors for suicide attempts. There was no difference between groups in terms of bipolar disorder subtype, onset age of bipolar disorder, total number of episodes, first and predominant episode type, suicide history in first degree relatives, severity of episodes, and hospitalization and being psychotic.Conclusion:Our study revealed that female gender, family history of mood disorder, and eating disorder are more frequent in bipolar patients with at least one suicide attempt.
IntroductionEsophagogastroduodenoscopy (EGD) is a diagnostic method used in the investigation of upper gastrointestinal system diseases. A high level of anxiety of patients who undergo EGD increases the duration of the procedure and the sedation and analgesic requirements. Sedation is used to increase patient comfort and tolerance by reducing the anxiety and pain associated with endoscopic procedures.AimIn this study, the effect of anxiety scores on medication doses was investigated in patients who underwent EGD under sedation.Material and methodsA psychiatrist, an endoscopist and an anesthesiologist conducted a prospective observational study blindly to investigate the effect of pre-procedural (before EGD) anxiety level on medication doses for sedation. Patients were divided into two groups, with and without additional medication doses.ResultsThe study included 210 consecutive patients who underwent EGD under sedation. The average STAI-S score was 40.28 and the average STAI-T score was 40.18. There was no relationship between anxiety scores and gender (p = 0.058, p = 0.869). Statistically significant results were obtained for anxiety scores with additional sedation dosing (p < 0.05). It was observed that an additional dose of medication was affected by age, body mass index and anxiety scores (p < 0.005). Patients who were young, had a low body mass index and had high anxiety scores had significantly higher additional dose requirements.ConclusionsThe medications used for sedation during EGD may be inadequate or an additional dose of medication may be needed for patients who have higher anxiety scores, younger age, and lower body mass index.
Objectives:To assess the impact of social anxiety disorder (SAD) comorbidity on the clinical features, illness severity, and response to mood stabilizers in bipolar disorder (BD) patients.Methods:This retrospective study included bipolar patients that were treated at the Department of Psychiatry, Haseki Training and Research Hospital, Istanbul, Turkey in 2015, and who provided their informed consents for participation in this study. The study was conducted by assessing patient files retrospectively. Two hundred bipolar patients were assessed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition axis-I (SCID-I) in order to detect all possible comorbid psychiatric diagnoses. The sample was split according to the presence of SAD comorbidity and the groups were compared.Results:The SAD comorbidity was detected in 17.5% (35/200) of the BD patients. The SAD comorbid bipolar patients were more educated, had earlier onset of BD, lower number of manic episodes, and more severe episodes. There was no difference between groups in terms of total number of episodes, hospitalization, suicidality, being psychotic, treatment response to lithium and anticonvulsants.Conclusion:Social anxiety disorder comorbidity may be associated with more severe episodes and early onset of BD. However, SAD comorbidity may not be related to treatment response in bipolar patients.
Studies to explain neurotic personality organization is no more. Studies emphasize the early family relationships are important in formation of this structure. Our study aims to assess personality traits and family relations of individuals with neurotic personality organization. 31 patients assessed in neurotic personality organization according to SCID-I and SCID-II followed by social psychiatry unit (Structured Clinical Interview for DSM Disorders), 31 control groups not taking diagnostic in the same tests were included in study. Socio-demographic data form was filled by interviewer, Beck Depression Inventory, MMPI (Minnesota Multiphasic Personality Inventory), State-Trait Anxiety Inventory, Family Assessment Scale, Sheehan Disability Scale by the participants. Control group was created from, of volunteers, subjects not taking any psychiatric diagnosis. Compared to neurotic patient group with control group; Shehan Disability Scale for Beck Depression Inventory scores; Family Assessment Scale for social life and family environment, business subscale and household responsibilities, for State-Trait Anxiety Inventory; hypochondria, depression, hysteria, and social introversion subscales for problem solving and behavior control subscale scores between groups and Minnesota Multiphasic Personality Inventory. Neurotic group was taking significantly diagnosis compared to control group for depressive disorder, anxiety disorders and avoidant personality disorder. Considered that avoidant personality structuring of neurotic individuals are at the forefront, the secondary anxiety and depressive symptoms progress. Said all these processes impair domestic problem-solving, behavior control skills of these individuals. Supports this process that the average score of neurotic patients are higher than control group for hypochondria, depression, hysteria, and social introversion subscales as results of MMPI.
AimIn this study we aimed to identify the perceptions and thoughts and their association with state/trait anxiety, depression that may lead to resistance to insulin treatment in patients with previously diagnosed type 2 diabetes mellitus (DM) patients in order to facilitate their compliance with insulin treatment.MethodIn this study, 120 patients were recruited with a previous type 2 DM diagnosis from the diabetes outpatient clinic. Patients were evaluated with sociodemographic data, State-Trait Anxiety Inventory, Problem Areas in Diabetes Scale, Insulin Treatment Appraisal Scale, Beck Depression Inventory.ResultsA majority of the patients were found to have resistance for startinginsulin treatment. Most of the patientswho were on other treatment alternatives reported that they wouldn’t use insulin even if they were prescribed insulin. A significant number of patients reported negative perceptions and thoughts about insulin treatment such as “insulin is a punishment”, “it is a shame to use insulin where other people can see”. In women injection phobia was significantly higher. Injection avoidance was significantly high and was more related to feeling insufficient about administration instead of worries about pain. Psychological resistance to insulin was significantly related to depression but not associated with state or trait anxiety levels. Lack of education and knowledge was found to be another important contributor to this resistance.ResultsType 2 DM patients show psychological resistance to insulin treatment due to negative perceptions and thoughts about the treatment. Cognitive interventions targeting these factors may be useful to overcome psychological insulin resistance and faciliate glisemic control.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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