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The 1st objective of the current study was to investigate the frequency and types of dissociative symptoms in patients with conversion disorder (CD). The 2nd objective of the current study was to determine psychiatric comorbidity in patients with and without dissociative symptoms. A total of 54 consecutive consenting patients primarily diagnosed with CD according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria who were admitted to the psychiatric emergency outpatient clinic of Sisli Etfal Research and Teaching Hospital (Istanbul, Turkey) were included in the study. The Structured Clinical Interview for DSM-IV Axis I Disorders, Structured Interview for DSM-IV Dissociative Disorders, and Dissociative Experiences Scale were administered. Study groups consisted of 20 patients with a dissociative disorder and 34 patients without a diagnosis of any dissociative disorder. A total of 37% of patients with CD had any dissociative diagnosis. The prevalence of dissociative disorders was as follows: 18.5% dissociative disorder not otherwise specified, 14.8% dissociative amnesia, and 3.7% depersonalization disorder. Significant differences were found between the study groups with respect to comorbidity of bipolar disorder, past hypomania, and current and past posttraumatic stress disorder (ps = .001, .028, .015, and .028, respectively). Overall comorbidity of bipolar disorder was 27.8%. Psychiatric comorbidity was higher and age at onset was earlier among dissociative patients compared to patients without dissociative symptoms. The increased psychiatric comorbidity and early onset of conversion disorder found in patients with dissociative symptoms suggest that these patients may have had a more severe form of conversion disorder.

BackgroundDrugs represent one of the etiologic causes of acute rhabdomyolysis (AR) with drug-induced rhabdomyolysis most commonly associated with HMG-CoA reductase inhibitors. AR etiology can also result from the use of diclofenac, a non-steroidal anti-inflammatory drug, and omeprazole, a proton pump inhibitor. Cases of AR triggered by pantoprazole have never before been reported, although it has been observed that its inclusion in multiple drug therapies can result in muscle events.Case presentationA 45-year-old man presenting with complaints of fatigue and extensive body pain was diagnosed with acute rhabdomyolysis. His symptoms started on the fourth day of the concomitant use of diclofenac and pantoprazole. The patient was using diclofenac 50-mg tablets once daily for 1 month and pantoprazole 40-mg tablets once daily during the previous week for headaches and pyrosis, resulting in an increase in his creatinine kinase levels to 3114 IU/L (reference range 24–190 IU/L) on the fifth day of concomitant use. His creatinine kinase levels returned to normal and his complaints disappeared after the seventh day of discontinuation of both treatments.DiscussionA third case of diclofenac-induced rhabdomyolysis was defined in which, different from previous cases, AR was detected during the concomitant use of diclofenac and pantoprazole. The timing of the symptom development and the limited number of AR cases induced by diclofenac and pantoprazole suggested a drug interaction.ConclusionThe close relationship between diclofenac and pantoprazole, and the cytochrome P450 and P-glycoprotein systems offers a strong indication that a drug interaction may be occurring. While evaluating the side effects of drugs in patients undergoing monotherapy, clinicians should also consider the mechanisms that play a part in drug absorption and distribution.

Quality of life and depression in schizophrenia patients living in a nursing homeObjective: Nursing homes are seen as alternative housing for patients with schizophrenia. However, it has not yet been established how suitable this accommodation is for schizophrenia patients. First aim of this study is to assess the quality of life and depression level in schizophrenic patients and compare this data with that of patients living with their families. Second aim is to assess factors related to the quality of living and depression state in all participants of this study. Method: This is a cross-sectional study conducted with patients presenting to the Psychotic Disorders Policlinic of the Beyhekim Psychiatric Clinic of Konya Training and Research Hospital consecutively between December 2012 and May 2013 who had received a diagnosis of schizophrenia according to DSM IV-TR. All participants were administered a sociodemographic data form, Brief Psychiatric Rating Scale (BPRS), Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), and Quality of Life Scale for Schizophrenia Patients (QLSSP). Results: CDSS scores were found to be significantly increased in schizophrenic patients living in nursing homes. Their QLSSP scores, including interpersonal relations, occupational role, mental symptoms, personal belongings/activity scores, and total scores were statistically significantly low. A significant negative correlation was observed between negative symptom levels and occupational area, mental findings, and the personal belongings/activity areas of quality of life. Between positive symptom levels and quality of life, only scores in the occupational area showed a significant negative correlation. A significant negative correlation between CSDS and QLS was observed in all areas. Conclusion: Quality of life and depression need to be evaluated in all schizophrenia patients, as they are conditions that significantly affect treatment and prognosis. Keywords: Depression, quality of life, schizophrenia ÖZET Bakımevinde kalan şizofreni hastalarında yaşam kalitesi ve depresyonAmaç: Bakımevleri şizofreni hastaları için alternatif yaşam alanları olarak görülmektedir. Ancak bu tür yerlerin şizofreni hastaları için ne kadar uygun olduğu sorusu henüz cevaplandırılmamıştır. Bu çalışmanın birinci amacı bakımevlerinde yaşayan şizofreni hastalarının yaşam kalitesini ve depresyon düzeylerini değerlendirmek ve ailesiyle yaşayan hastalarla karşılaştırmaktı. İkinci amacı ise çalışmaya alınan tüm hastaların yaşam kalitesi ve depresyon durumlarıyla ilişkili faktörlerin değerlendirilmesiydi. Yöntem: Bu çalışma Aralık 2012-Mayıs 2013 tarihleri arasında Konya Eğitim ve Araştırma Hastanesi, Beyhekim Psikiyatri Kliniği, Psikotik Bozukluklar Polikliniğine ardışık olarak başvuran DSM-IV-TR'ye göre şizofreni tanısı alan hastaların katıldığı kesitsel bir çalışmadır. Tüm katılımcılara sosyodemografik veri formu, Kısa Psikiyatrik Değerlendirme Olçeği (KPDÖ), Pozitif ve Negatif Sendrom Ölçeği (PNSÖ), Calgary Şi...

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Introduction: This study aims to compare sociodemographic characteristics of the patients with bipolar disorder (BD) with and without comorbid dissociative disorder (DD) and to investigate the eventual effect of the comorbidity on the treatment. Methods:We enrolled a total of 149 patients diagnosed with BD and treated as inpatients consecutively in Şişli Etfal Hospital, Psychiatry Clinic between 2010 and 2011. For the patients who were diagnosed with DD using SCID-D and with BD using SCID-I, sociodemographic characteristics, YMRS, HAM-D, BPRS, DES scores and duration and number of hospital stays were evaluated. Results: 23 patients (15.4%) had dissociative disorder not otherwise specified (DD-NOS), 4 patients (2.6%) had dissociative identity disorder (DID) and 1 patient (0.6%) had dissociative amnesia. BD patients with comorbid DD were found to be predominantly female (p=0.015) and younger (p=0.002) and to have significantly higher DES scores than BD patients without DD (p<0.001). The total score of DES was correlated with duration hospital stay (p=0.001, Spearman r=0.336) in the total sample. Total HAM-D score at the time of admission was significantly higher in the comorbidity group (p=0.027), and suicide item was found to be significantly higher both at admission and at discharge (p<0.001 and p=0.035). Among BPRS scores at admission, hallucinatory behavior item was found to be higher in the comorbidity group (p=0.019). Among YMRS scores both at admission and at discharge, velocity and amount of speech item (p=0.027) and insight item at admission (p=0.006) was found to be significantly higher in the pure bipolar group (p=0.018). Conclusion:In patients with BD, DD comorbidity should be investigated. The BD patients with DD comorbidity tend to be female and younger, and show higher depression scores, leading to a prolonged hospital stay. In the presence of dissociation comorbidity, attempts and number of suicides and hallucinatory behaviors seem to be increased.

Internet addiction among eighth grade students: Çanakkale sample Özet Amaç: İnternetin yaygın ve etkili kullanımı, özellikle çocuklar ve gençler olmak üzere tüm toplumu etkilemektedir. Bu çalışmanın amacı ergenliğin başlangıç dönemlerinde yer alan ilköğretim 8. sınıf öğrencilerinde internet bağımlılığı sıklığını araştırmak ve gelir düzeyi ile ilişkisini saptamaktı. Gereç ve Yöntem: Çalışmamız kesitsel-tanımlayıcı desende bir çalışma olup evrenini Çanakkale il merkezinde bulunan 8. sınıf öğrencileri oluşturmuştur. İnternet bağımlılığını tespit etmek amacıyla Young'ın geliştirdiği İnternet Bağımlılığı Ölçeği kullanılmıştır. Bulgular: Çalışmaya %47,0'si (s = 120) kız, %53,0'ü (s = 137) erkek olmak üzere toplam 257 öğrenci alındı. Erkek öğrencilerin ölçek puan ortalaması 29,3 ± 20,0, kız öğrencilerin ise 26,5 ± 17,0 olup aralarındaki fark istatistiksel olarak anlamlı değildi (p>0,05). İnternet bağımlı öğrenci sıklığı %0,8 (s = 2) idi ve her iki bağımlı öğrenci de yüksek gelir düzeyli ailelerin çocuklarının okuduğu okulda eğitim görmekteydi. Olası internet bağımlılığı erkek öğrencilerde kızlardan daha fazlaydı ancak istatistiksel olarak anlamlı farklılık yoktu (p>0,05). Gelir düzeyi yüksek olan ailelerin çocuklarının okuduğu okullarda; düşük olan okula göre internet bağımlı ya da olası bağımlı olan öğrenci sayısı anlamlı olarak daha yüksekti (p = 0,018). Sonuç: Çalışmamıza katılan ilköğretim düzeyindeki adolesan öğrencilerde internet bağımlılığı oldukça düşüktür. Olası internet bağımlılığında erkek cinsiyet ve yüksek gelir düzeyi etkili gibi görünmektedir.

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