Optical Coherence Tomography Findings in Bipolar Disorder Patients and the Related Factors.

Background: This study's purpose is to determine the effects of current episode and the mood stabilizers on chorioretinal layer thicknesses of bipolar disorder (BD) patients using spectral-domain optical coherence tomography (SD-OCT). Methods: Sixty-seven patients were diagnosed with BD I and using lithium (Li) or valproic acid (VPA), of whom 20 were manic, 24 were depressive, and 23 were in remission, and 49 healthy individuals were included in the study. Peripapillary retinal nerve fiber layer (RNFL), ganglion cell layer, and macular thicknesses of the participants were measured automatically using SD-OCT, and their choroid layer thicknesses were measured manually using the depth imaging mode of SD-OCT. Statistical analysis of the data was performed using Statistical Package for the Social Sciences version 23.0. Results: The patient group's mean age was 39.78 ± 11.78, and the control group's mean age was 42.06 ± 12.10. The mean disease duration was 13.22 ± 8.23 in the patient group, and 26 patients were using Li. While peripapillary RNFL thicknesses were lower in the patient group (P < .05), other layer measurements were similar between the groups. Moreover, the episodes experienced by BD patients did not affect chorioretinal SD-OCT measurements. The patients on VPA had significantly lower RNFL thicknesses compared to the control and the Li groups, and all chorioretinal measurements were similar between the Li and the control groups. Conclusion: As a result of the study, it was established that neurodegenerative processes play a role in the pathophysiology of BD and the usage of Li is protective against the neurodegeneration of RNFL. Retinal changes measured with SD-OCT can be used for the diagnosis and prognosis of BD and for evaluating responses to mood stabilizers.

Comparison of Hospitalization Rate and Social Functioning of Patients Receiving Community Mental Health Service and Outpatient Psychiatry Policlinic.

BACKGROUND: This study aimed to compare the hospitalization rates and social functioning of patients receiving Community Mental Health Center (CMHC) services and those treated in the psychiatry policlinics of hospitals. SUBJECTS AND METHODS: A total of 145 patients who were diagnosed with schizophrenia or schizoaffective disorder according to DSM-V criteria were included in the study. Of them, 81 received CMHC services at least for one year (CMHC group) and 64 were followed-up in psychiatry policlinics (hospital group). A personal information form containing socio-demographic and disease/treatment characteristics and hospitalization counts in the last year, Social Functioning Assessment Scale (SFAS) and Positive and Negative Syndrome Scale (PANSS) were used to collect data. The hospital group received antipsychotic medication therapy while a semi-structured psycho-social intervention program combined with antipsychotic drug therapy was applied in the CMHC group. The hospitalization counts, SFAS and PANSS scores of the groups were compared and the correlation of related factors were evaluated. RESULTS: Hospitalization rates were 0.21±0.56 in the CMHC group and 1.03±1.31 in the hospital group. The mean hospitalization rate was significantly lower in the CMHC group (p<0.001). The mean scores for the overall SFAS and its interpersonal relationships and entertaining subscale; were significantly higher in the CMHC. The mean overall PANSS scores were 84.23±15.28 and 99.50±15.99 in the CMHC and hospital groups, respectively (p<0.05). There was a moderate positive relationship between hospitalization rates and all PANSS scores. CONCLUSIONS: CMHC services led to a serious decrease in hospitalization rates, increased the psychosocial functioning of patients and improved their compliance to treatment. Transition to a community-based mental health model should be accelerated for holistic treatment. Further longitudinal studies with a control group should be conducted.

Effects of Hypnotherapy on Weight Loss and thus on Serum Leptin, Adiponectin, and Irisin Levels in Obese Patients.

Objective: This study aimed to investigate effects of hypnotherapy on weight loss and thus on leptin, adiponectin (ADP), and irisin levels in obese patients who presented to the psychiatry outpatient clinic to participate in hypnotherapy sessions to develop a healthy and balanced diet. Methods: The study sample included 32 individuals with a body mass index (BMI) of ≥30 and who completed the 10-week hypnotherapy. First, the Personal Information Form was handed out to the participants and then each participant's weight (in the morning on an empty stomach) and height were measured and BMI was determined. Five-milliliter blood samples were drawn before the first session, and then irisin, leptin, and ADP levels were measured using the enzyme-linked immunosorbent assay method. Then, they participated in hypnotherapy sessions once a week for 10 weeks. At the end of the 10-week hypnotherapy, 5 mL of blood was taken again and the aforementioned biochemical analyses were performed. BMIs were measured again. Results: The mean BMI values of the patients were 33.43 ± 5.28 and 31.45 ± 4.98 at the beginning and end of the hypnotherapy sessions, respectively. Serum leptin, ADP, and irisin levels, which were 9.48 ± 5.48, 6.73 ± 3.27, and 1.43 ± 1.14, respectively, at the beginning of the hypnotherapy sessions, were 6.47 ± 2.69, 7.68 ± 3.34, and 1.53 ± 1.21, respectively, at the end of the hypnotherapy sessions. The results showed that BMI and serum leptin levels decreased significantly after the hypnotherapy sessions, whereas serum ADP and irisin levels increased significantly. Conclusions: This study indicates that hypnotherapy in obesity treatment leads to weight loss in obese patients and thus to considerable changes in leptin, ADP, and irisin levels. Hypnotherapy is easy to apply, cheap, and effective; has no potential for side effects; and can be applied both alone and in combination with other treatments. However, to confirm its effects, further studies should be conducted on this issue.

The effect of training given to parents with mentally disabled children on their life satisfaction self-stigma of seeking help depression and stress-coping styles.

BACKGROUND: It is important to identify problem areas of parents with mentally disabled children, to support them, to address their stress sources and to effectively cope with them. The aim of this study is to evaluate the effect of training given to parents with mentally disabled children on their life satisfaction, self-stigma of seeking help, depression and stress-coping styles. MATERIAL: Families with disabled children who continued their education at the Special Education Centers in Sivas created the sample of this pre- and post-test study (with control group). The data were collected with the Satisfaction With Life Scale (SWLS), the Beck Depression Inventory (BDI), the Self-Stigma of Seeking Psychological Help Scale (SSPHS) and the Ways of Coping Questionnaire (WCQ). The scales were re-applied to the experimental group (n = 75) after the application of scales and 5-week training. Individuals in the control group were not given any training. The Mann-Whitney U test, t test and Kruskal-Wallis variance analysis were used in the evaluation of the data. RESULTS: The mean SWLS score was 19.14 ± 7.24 (min: 3; max: 31) before the training and 21.68 ± 7.39 (min: 6; max: 35) after the training. The mean BDI score was 16.92 ± 10.84 (min: 1; max: 60) before the training and 10.24 ± 7.77 (min: 0; max: 33) after the training. The mean SSPHS score was 58.18 ± 9.96 (min: 32; max: 82) before the training and 52.65 ± 14.28 (min: 28; max: 84) after the training. The mean optimistic approach score of SSPHS was 9.73 ± 2.67 (min: 2; max: 15) before the training and 10.58 ± 2.19 (min: 4; max: 15) after the training. It was determined that the difference between mean scores of the control group before and after the training was not significant (p > .05). CONCLUSION: The training has positively affected the decrease in depression and self-stigmatization, and the increase in life satisfaction and stress-coping styles after the training. It is recommended to plan research studies to identify the need for support of parents, and to structure the trainings to be given according to the results of the educational intervention researches.

Hospitalization and Some Sociodemographic Characteristics of Patients Registered with a Community Mental Health Center.

One of the most important indicators evaluating the effectiveness of community mental health centers is the decrease in hospitalization rates of registered patients. The aim of our study was to compare the annual hospitalization rates of patients receiving community mental health services before enrollment with the annual hospitalization rates after enrollment. The study included 400 patients with a registration period of at least 1 year as of the end of 2018. Wilcoxon signed rank test was used to test the significance of the difference between pre-registration and post-registration patients' annual hospitalizations. The annual hospitalization rates (0.32 ± 0.35) and the annual hospitalization rates (0.15 ± 0.35) before and after registration were found to be statistically significant (p < 0.001). Annual hospitalization rates decreased by 54.58%. Our Community Mental Health Center, which provides community-based mental health services, has led to a significant decrease in annual hospitalization rates thanks to the services provided.

Rates and correlates of employment in patients with schizophrenia: A multicenter study in Turkey.

BACKGROUND: There is not enough information regarding the participation in the working life of the patients with schizophrenia in Turkey. AIMS: The aim of this study was to examine the occupational experiences of patients with schizophrenia before and after the illness and to investigate the factors that predict work participation. METHODS: The data on occupational life of the patients with schizophrenia, which were treated as outpatients in six different centers, were examined. The rates of participation in working life before and after the disease were evaluated. Patients with and without occupational life history after the disease were compared in terms of demographic characteristics. Factors predicting participation in work life after the disease were analyzed by logistic regression analysis. RESULTS: Out of the 587 patients evaluated in the study, 73% were males, 73% were single, the mean age was 42, mean level of education was 9 years and the average duration of illness was 18 years. The duration of the employment before the disease was higher than that after the disease regarding expected working time. The rate of employment was 11% currently, 14% in the last year, 62% after the disease and 83% for the lifetime. While the factors that predicted to be in working life after the illness were male gender (odds ratio (OR) = 2.9), diagnosis of schizoaffective disorder (OR = 2.6), high level of education (OR = 1.2) and employment history before the onset of the illness (OR = 1.0), only the shorter duration of illness (OR = 1.1) predicted the current working status when the gender variable was excluded. CONCLUSION: Rate of employment of patients with schizophrenia living in Turkey was low as in other countries. Good premorbid functioning seems to determine participation in occupational life after the illness.

Thiol Disulfide Homeostasis in Schizophrenic Patients Using Atypical Antipsychotic Drugs.

OBJECTIVE: Schizophrenia is a severe, debilitating mental disorder characterized by behavioral abnormalities. Although several studies have investigated the role of oxidative stress and the effects of antipsychotic drugs on oxidative markers in schizophrenia, adequate information is not available on these issues. The aim of this study is to determine the changes in oxidative status and thiol disulfide homeostasis in schizophrenic patients using atypical antipsychotic drugs. METHODS: Thirteen schizophrenic patients using atypical antipsychotic drugs and 30 healthy controls were included this study. The concentrations of total oxidant status (TOS), total antioxidant status (TAS), native thiol, total thiol, and disulfide levels were determined in the study population. RESULTS: The TAS (p=0.001), total thiol, and native thiol levels (p＜0.001) were higher in the patients compared to the controls, whereas the TOS and disulfide levels were lower in the patients than in the controls (p＜0.001). CONCLUSION: These results may suggest that atypical antipsychotic drugs have a useful therapeutic effect by reducing oxidative stress via the inhibition of the formation of disulfide bonds. The study population number was one of the limitations of this study. Therefore, further studies are needed to establish the association between thiol disulfide homeostasis in schizophrenic patients using atypical antipsychotic drugs.

Antipsychotic Use Pattern in People with Psychotic Disorder Living in Board and Care Facilities.

INTRODUCTION: The aim of this survey is to determine the pattern of antipsychotic drug use in patients with psychotic disorders, living in board and care facilities and to investigate the related factors. METHODS: We evaluated the antipsychotic drug use pattern in outpatients with psychotic disorders according to DSM-IV, living in board and care facilities. Patients using polypharmacy at least one month were compared with patients using monotherapy in terms of clinical and demographic characteristics. RESULTS: Antipsychotic polypharmacy (with two: 34%, with more than two: 28%) was identified in 62% of the patients. The most frequently prescribed combination was olanzapine+quetiapine (13%), the rate of first and second generation combination was 50%, the rate of second generation antipsychotic combination was 44%, and the rate of first generation anytipsychotic combination was 4% in the two antipsychotic drug combination group. The rate of clozapine use was 3%. Use of polypharmacy was associated with the diagnosis of schizophrenia and schizoaffective disorder, young age, suicidal behavior, multiple hospitalizations, clinical severity, and the need of anticholinergic drug. CONCLUSION: The ratio of using more than two antipsychotic drug combination is high (28%) in psychotic patients living in board and care, and rate of clozapine use is low, which shows that clinical practice is inconsistent with the treatment guidelines recommendations. It appears that further education to rationale antipsychotic drug use in psychiatric practices is required.