Comparison of Metacognitive Beliefs Between Patients with Unipolar Depression and Bipolar Depression

ABSTRACT Objective: The aim of this article is to compare differences in metacognitive beliefs between bipolar disorder type I depressed (BPD1) patients with Unipolar Depression (UPD) patients, and a control group; and to discuss the relationship between metacognitive beliefs and depression parameters. Methods: Sixty six consecutive outpatients with a diagnosis of depressed BPD1, 70 patients with UPD and 70 healthy controls were enrolled in the study. Following assessment with the Sociodemographic Data Form, Structured Clinical Interview for DSM-IV (SCID-I), Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scales (HAM-A), Young Mania Evaluation Scale, and the Metacognition Questionnaire-30 (MCQ-30). Results: UPD and BPD1 patients included in the study had higher scores in metacognitive beliefs other than positive beliefs compared with healthy controls (p<0.05), but no significant difference was found between the BPD1 and UPD groups (p>0.05). A statistically significant positive correlation was observed between the HAM-A, HAM-D scores and MCQ-30 scores in UPD group (p<0.05) but not in BPD1 group (p>0.05). Discussion: The metacogitive structures of UPD and BPD1, may be helpful in identifying and choosing the right treatment modality. We think that our results may have implications for the metacognitive approaches in the treatment of BPD1.

Optical coherence tomography findings in bipolar disorder: a preliminary receiver operating characteristic analysis on ganglion cell layer volume for diagnosis

Abstract Background Optical coherence tomography (OCT) has been recently used to investigate neuropsychiatric disorders. Objective The aim of this study was to compare the retinal nerve fiber layer thickness (RNFLT) and the ganglion cell layer (GCL) volume in patients with type 1 bipolar disorder (BPD1, diagnosed according to DSM 5) to the values in healthy controls. Methods Eighty consecutive outpatients with a diagnosis of euthymic BPD1 and 80 healthy controls were enrolled in the study. Following assessment with the Sociodemographic Data Form, Structured Clinical Interview for DSM-IV (SCID-I), Hamilton Depression Scale and Young Mania Evaluation Scale, both groups underwent Optical coherence tomography (OCT). Results The mean RNFL thickness and mean GCL volume were significantly lower in the BPD1 group than in the controls (p < 0.05). The GCL global value had a significant and independent effect in distinguishing the BPD1 patients from the controls. A cut-off value of 101 mm3 for global GCL volume was proposed to distinguish BPD1 patients from controls with a sensitivity of 87.5%. Discussion Lower values of GCL volume and RNFLT in patients suffering from BPD1 suggest that neurodegeneration may occur during the course of BPD and that this degeneration can be characterized in particular by a thinning of the GCL volume.

Barotraumatic Subcutaneous Orbital Emphysema after Nose Blowing: Case Report.

Orbital subcutaneous emphysema is defined as the abnormal presence of air within the periorbital soft tissue. It occurs generally as a result of blunt or penetrating facial trauma. Spontaneous barotraumatic emphysema is a very rare entity that generally results due to a sudden increase in the intraorbital pressure. If there is not an obvious visual acuity loss even with high ocular pressure, it is generally managed conservatively. However prolonged elevation of intraorbital pressure may cause an irreversible, ischemic visual loss secondary to an ischemic optic neuropathy or an acute central retinal artery occlusion. Emergency decompression may be required. Here we are presenting a patient with barotraumatic orbital subcutaneous emphysema, occurring after forceful nose blowing who was managed conservatively without any complications.

Analysis of Violence in a Crowded Emergency Room.

Aims: There is abundant evidence to suggest that health care staff are increasingly being exposed to violent incidents at their workplace. The purpose of our study was to identify the role of crowding in producing violence that occurs in emergency department as well as to outline the factors that affect the types of violence. Study Design: In this prospective study we collected incidents of violence against emergency staff by patients or their relatives. A survey with 20 questions about the event was completed by emergency staff just after the event. Also information about crowding at that time was recorded as well as the area of the event. Statistical analysis was done with SPSS 16.0. Place and Duration of Study: Department of Emergency Medicine, Marmara University Pendik Training and Research Hospital, Between April 1 and June 1, 2012. Methodology: A total of 116 acts of violence were reported during the 61 days of this study. 79 of 116 cases (68.1%) were verbal, 16 (13.8%) physical, and 21 (18.1%) were both verbal and physical. The information about each event was entered into a database and pooled for analysis. Results: The most common victims of violence were physicians (38.8%) and security personnel (31.0%). The presence of security personnel in the environment increases the risk of physical violence (P=.017). The average total number of patients waiting for examination or results of examinations was 24.9 ± 1.4 (95% CI, 22.3 – 27.5). It was observed that the violence increased when the number of people was close to this number and reduced when the crowding increased above this average. Conclusions: The existence of security personnel alone is not sufficient to prevent violence; new steps should be taken to prevent the entrance of the patients’ relatives to inside of the treatment areas of emergency departments.