Clinical, Biological and Genetic Predictors of Lithium Treatment Response

Author(s): Hazan Tomar Bozkurt,Vefa Erbasan,Ümran Eğilmez,Barış Şen,Memduha Aydın,Kürşat Altınbaş / Language(s): English Issue: 4/2018

Lithium was discovered by the Swedish Arfvedson at the beginning of the 1800s and began to be used in psychiatry for the past 1950s. Lithium, as a mood stabilizer, is the gold standard and first choice treatment agent for the treatment of bipolar disorders in adults. However, it is mostly difficult in clinical practice to predict which patient would respond to the treatment with lithium well due to the huge variation in patients’ characteristics. Clinicians seem to focus primarily on identifying a clinical phenotype to foresee lithium treatment response. In this article, researches on predictors of the lithium treatment response were reviewed and evaluated in four titles as clinical, biochemical, neuroimaging and genetic predictors.

An Example of a Model for Practicing Community Mental Health Nursing: Recovery

Author(s): Beyhan Bag / Language(s): English Issue: 4/2018

There are some uncertainties about the services that will be offered to patients with mental disorders in the community mental health centers opened in our country. One-fourth of the employees in these centers are nurses. This is an important figure that could affect the quality of the services offered. In order to improve the quality of the services offered, nurses need models that can be applied in the field. In this sense, “Recovery” model, is a model that is quite suitable for the community mental health services which centers the individual as a part of its basic philosophy. The aim of this study is to define the “Recovery” model and to discuss it as model for the treatment and maintenance of patients by nurses working in community mental health centers.

Complicated Grief: Epidemiology, Clinical Features, Assessment, and Diagnosis

Author(s): Özge Enez / Language(s): English Issue: 3/2018

A loss is an adverse external event which a person has no control over and changes one's belief system and cognitions. Normal grief is a normal reaction to loss and refers to the distress resulting from bereavement. However, complicated grief is a syndrome where normal grief is unusually prolonged because of complications in the natural healing process; namely the insufficient integration of a new situation into pre-existing cognitive structures and distorted beliefs during the grieving process. Complicated Grief is a disorder characterised by an inability to accept the death, intense yearning, avoidance, somatic distress, social withdrawal and suicidal ideation and has a distinct cluster of symptoms which can be distinguished from other psychiatric disorders. The aims of this review are to give an overview of abnormal forms of grief reactions and risk factors, to introduce proposed diagnos-tic criteria for complicated grief, to inform about the assessment tools, and to demonstrate the distinction between complicated grief and other psychiatric disorders.

Psikiyatride ve İletişim Eğitiminde Simüle Hasta Uygulamaları

Author(s): Neşe Mercan,Celale Tangül Özcan,Mehmet Sinan Aydın / Language(s): Turkish Issue: 3/2018

One of the effective methods of teaching to earn cognitive and psychomotor behaviors for students is interactive methods in which they actively participate in learning process. Simulated/standardized patient can be used in simulation application which is one type of the interactive methods. The simulant patient consists of those who have been trained to act and display the real patient scenario. The simulant patient provides a safe learning environment based on experience in virtual or laboratory environment prior to the actual patient environment for students. This application helps students to increase the level of knowledge and skills, their self adequacy, their motivation and their safety, reduce their level of anxiety and improve their clinical decision making skills. The aim of this article is to briefly review simulated patient practices in communication training and psychiatry.

Koroner Kalp Hastalıklarının Yönetiminde Uyum ve Öz Yeterlik

Author(s): Selma Turan Kavradım,Zeynep Özer / Language(s): Turkish Issue: 3/2018

Coronary heart disease is an important health problem all over the world due to its high mortality and prevalence. Physical, social, psychological and occupational constraints affect individuals' quality of life and self-efficacy perceptions negatively and make difficult adaptation of treatment. Today, the importance of lifestyle changes is emphasized to control risk factors in coronary heart disease. The concept of "self-efficacy" has an important place in achieving and adapting lifestyle changes. Self-efficacy is defined as "the belief that one can initiate an action that can be effective on what is happening around him or her and continue until the outcome is achieved". It is seen that the evidence-based interventions implemented by health personnel are effective in reducing post-discharge complications, increasing the quality of life and self-efficacy levels, and adapting to lifestyle changes.

Structural and Functional Neural Correlates of Anorexia Nervosa

Author(s): Deniz Atalayer / Language(s): English Issue: 3/2018

The findings from neuroscience have shaped our understanding in the past decade regarding the way we perceive psychiatric illness. In addition to the more conventional theories that are based solely on the psychological and sociocultural factors to explain psychiatric disorders, there is growing evidence supporting a multifactorial etiology with genetic and neurological components. Anorexia nervosa, a life-threatening psychiatric disorder with relentless restrictive eating resulting in extremely low body weight, is one such illness that may be categorized as a brain disorder based on the recent findings. Although inconsistencies exist, several studies investigated the structural and the neurochemical alterations in the brain as well as the functional significance and the cognitive manifestations of these abnormalities in anorexia nervosa patient. This review aims to summarize the current literature on the neural aberrations and several treatment approaches targeting these abnormalities in anorexia nervosa.

Link between Impulsivity and Overeating: Psychological and Neurobiological Perspectives

Author(s): Deniz Atalayer / Language(s): English Issue: 2/2018

In most basic terms impulsivity is defined as a tendency to act without control. Impulsivity has been implicated in the onset, symptomatic expression, and maintenance of overeating. Specifically, high impulsivity and associated poor inhibitory control, along with sensation seeking and reward sensitivity, as well as negative affect have been found to have an interaction effect on emotional eating, which may lead to binge eating and obesity. Moreover, associations between overeating and impulsive behaviors such as difficulty in response inhibition, planning, attention, addiction, or risk taking etc. have been previously shown. The purpose of this review is to summarize the evidence from psychology regarding the potential role of the impulsivity trait in overeating, with implications on the treatments for obesity and binge eating.

Sosyal Anksiyete Bozukluğunun Alt Tipleri: Heterojen Bir Tanı Kategorisi

Author(s): Dilay Eldoğan / Language(s): Turkish Issue: 2/2018

Social anxiety disorder, which has a prevalence rate of 7%, is among the psychopathologies resulting difficulties in school and work life and interpersonal relationships of the individuals. Although the findings of the research agree on the destructive role of social anxiety disorder on individuals, there is no consensus on whether social anxiety disorder is differentiated between individuals. The purpose of this study is to examine the quantitative and qualitative differences among the subtypes in the field of social anxiety disorder literature and to evaluate the reflections of these differences on suggestions about the diagnosis processes.

Tardif Diskinezi ve Tedavi Yaklaşımları

Author(s): Mehmet Emin Demirkol,Şilan Şenbayram,Gökçen Doğangüneş,Lut Tamam / Language(s): Turkish Issue: 2/2018

Tardive dyskinesia is an iatrogenic movement disorder with an incompletely determined etiology. Involuntary movements can effect oral, lingual, facial, corporal muscles and can be permanent. Tardive dyskinesia is one of the most important side effects of long term antipsychotic use. There is some decrease in tardive dyskinesia rates after common use of second generation antipsychotics but tardive dyskinesia can be seen even after use of second generation antipsychotics. There are some treatment options from drug-free observation to deep brain stimulation in tardive dyskinesia. The aim of this article is to review epidemiology, etiology, risk factors, pathophysiology and treatment options of tardive dyskinesia.

Şizofreni Etyolojisinde Mikrobiyotanın Rolü

Author(s): Şükrü Kartalcı / Language(s): Turkish Issue: 2/2018

In recent years, the role of microbiota in the etiology of schizophrenia has been a focus of investigation. It is now increasingly recognized that bidirectional communication exists between brain and gut microbiota. Evidence that indicate possible microbiota alteration in schizophrenia includes structural damage to the gastrointestinal tract, a heightened immune response to infectious pathogens and food antigens. It is proposed that an altered microbiome may contribute to abnormalities in metabolic function in schizophrenia. The aim of this article is to review recent literature on connection of the microbiota and schizophrenia.

Dikkat Eksikliği Hiperaktivite Bozukluğu ve Genetik

Author(s): Fatih Hilmi Çetin,Yasemen Işık / Language(s): Turkish Issue: 1/2018

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder of which three basic symptoms are lack of attention, over-activity that is improper to the age and impulsivity, all of which appear in childhood. Its incidence is %5-12 in children and %4.4 in adults throughout the world. ADHD provides a basis for important problems for both patient, family and society and thus it is important to diagnose the disorder early and understand the factors that create predisposition to the disorder. ADHD is a multifactorial disorder with an etiology of genetic and environmental com-ponents. The importance of genetic factors first implied by Cantwell and Morrison is supported by many studies ever since. All these studies showed that inheritance rate of ADHD is as high as %76. The aim of this article is to explain ADHD genetics in categorization of twin studies, adoption studies, family studies, segregation analyzes and molecular genetic researches and to review the genetic component of ADHD.

İkincil Travmatik Stres

Author(s): Ayla Kahil,Nejla Refia Palabıyıkoğlu / Language(s): Turkish Issue: 1/2018

Traumatic events do not only affect the person who was directly exposed to the incident, but they might also lead to some reactions on people with whom they interact. It is argued that, reactions given to a traumatic event by being exposed to the incident either primarily or secondarily, resemble each other. While in primary exposure the perceived threat is subjective, in secondary exposure the threat belongs to the person one interacts with. Secondary exposition to trauma may lead to re-experiencing, avoidance, and increased arousal symptoms as well as impairment in daily functioning. Briefly, secondary exposition to a traumatic incident induces parallel reactions as in those who are primarily exposed. In addition to these, taking specific precautions help decreasing the negative effects of secondary traumatic stress. This review focuses on the secondary traumatic stress and secondary traumatic stress disorder of workers who offer service in relief operations. For this aim, related theoretical concepts along with the literature studies are presented and information regarding ways of coping with the negative effects of secondary traumatization is discussed.

Gebelik ve Postpartum Dönemde Obsesif Kompulsif Bozukluk

Author(s): Mehmet Emin Demirkol,Lütfiye Şimşek,Hamdi Yılmaz,Lut Tamam / Language(s): Turkish Issue: 1/2018

Pregnancy and postpartum period are risky periods about occurrence and recurrence of many psychiatric disorders. General opinion is that obsessive compulsive disorder is more common in pregnancy and postpartum period than the normal population. Obsessions and compulsions should be questionned in these periods. Obsessions are generally about contagion and agression, compulsions are generally about washing and cleaning. Selective serotonin reuptake inhibitors and cognitive behavioral therapy are the first rank treatment options. In this article we briefly reviewed prevalence, etiology, comorbidities, clinical features and treatment options of obsessive compulsive disorder in pregnancy and postpartum period.

Effectiveness of Psychotherapy Based Interventions for Complicated Grief: A Systematic Review

Author(s): Özge Enez / Language(s): English Issue: 4/2017

Grief is a normal, dynamic and multidimensional process, which relates to the individuality and uniqueness of reactions to loss. However, complicated grief is a syndrome where normal grief is unusually prolonged because of complications in the natural healing process. Approximately one third of grieving individuals develop complicated grief symptoms. The individuals suffering from complicated grief tend to report clinical complaints that refer to anxiety, depression, psychical symptoms and life-threatening behaviours. The aims of this study were: to identify which psychother-apy-based interventions were designed for the treatment of complicated grief; and to make an infer-ence about the effect of these interventions.

Psychoeducation and Work Practices in Chronic Mental Disorders

Author(s): Nazan Deniz Turan / Language(s): English Issue: 1/2019

The unemployment, one of the difficulties faced by individuals with the chronic mental disorder who are stigmatized and marginalized by the society in terms of social identity, is an important problem. Providing occupation and a regular job for individuals with chronic mental disorders has a great importance in terms of increasing their functionality in the society. In this context, patients with chronic mental disorder, who are stigmatized and identified by the society, are examined in this review, in terms of "social identity theory".

Lithium Associated Side Effects and Neurotoxicity: Is Lithium Neurotoxicity Related to Iron Deposition?

Author(s): İlkay Keleş Altun,Neslihan Kılıç,Emrah Yıldızoğlu,Murat İlhan Atagün / Language(s): English Issue: 2/2019

Lithium is a mood stabilizer that Australian psychiatrist John Cade and the Swiss Baastrup and Schou’s pioneering studies brought in the treatment of bipolar disorder. In current guidelines, it is still consid-ered as first line therapy for acute mania, depression and remission periods. Along with numerous neurotrophic and cytoprotective effects, lithium may rarely cause neurotoxicity. Neuro-toxicity might be related with dose dependent or independent. Mechanism of neurotoxicity has not been identified yet. A possible reason of lithium neurotoxicity is that lithium complicates iron efflux from neurons by inhibiting the tau cascade. Accumulation of iron may increase hydroxyl radical formation, resulting in oxidative neurotoxicity. On the other hand, mechanisms that may alleviate iron deposition should also be considered. This review will address the cardiac and met-abolic side effects of lithium and clinical features and biochemical regimes of neurotoxicity, and its relationship with iron accumulation.

Ecological System Model Approach to Self-Disclosure Process in Child Sexual Abuse

Author(s): Muhammet Cevher Tat,Ahu Öztürk / Language(s): English Issue: 3/2019

The child has a potential of action initiated spontaneously and voluntarily which is also a precious tool against abuse: named self-disclosure. However, the disclosure of self is, in fact, a complex phenomenon related to a bunch of multileveled effects such as the child's developmental characteristics, family background and also the cultural and societal attitudes towards the child and children rights. The obstacles that cause child victims not to appear and recognized are even threatening the effectiveness of intervention strategies for dealing with sexual abuse. This paper aims to provide an in-depth elucidation of the aspects that influence the self-disclosure in child sexual abuse. To handle the relations of the main factors inclusively involved in child self-disclosure; the Ecological System Model of Urie Bronfenbrenner was utilized.

Grief Support Programs Implemented to Reduce the Effects of Grief on Family

Author(s): Buket Şİmşek Arslan,Kadriye Buldukoğlu / Language(s): English Issue: 3/2019

Death is inevitable for each individual. The grief emerged as a result of death is felt most intensive in the family. Losing one of family members causes significant changes in the balance of the family. It is very important that the family which tries to reconstruction is supported by evaluating the life cycle, values and belief systems, the role of the lost individual in the family, ties with family members, and the level of functionality of the family. For this aim, different support programs are implemented for grieving families. The main aim of these programs is to ensure that the family members overcome in a healthy way during the grieving process. In this context, this review examines grief effects on family and provides examples from family support programs during the grief process.

Post-stroke Neuropsychiatric Problems

Author(s): Ali Görkem Gençer,Çiçek Hocaoğlu / Language(s): English Issue: 4/2019

Stroke is the most frequent and significant reason of disability in society. The underlying basic pathophysiological mechanisms of stroke are infarct and hemorrhage. A total of 20% patients that had a stroke became dependent. Dementia, depression, anxiety disorder, mania, psychosis, pathological emotions, apathy and catastrophic reactions constitute challenging clinical presentations that occur after stroke. In this review, current data about epidemiology, etiology, clinic and treatment of psychopathologies that occur in poststroke period will be discussed.

Şizofrenide Görülen Tıbbi Durumlar

Author(s): Betül Demirel Döngel,Lut Tamam,Gül Kır / Language(s): Turkish Issue: 3/2017