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Öğe Acute sleep deprivation immediately increases serum GDNF, BDNF and VEGF levels in healthy subjects(Springer Japan Kk, 2022) Gorgulu, Yasemin; Caliyurt, Okan; Cinar, Rugul Kose; Sonmez, Mehmet BulentAcute sleep deprivation upregulates hippocampal neurogenesis. Neurotrophic factors such as glial cell line-derived neurotrophic factor (GDNF), brain-derived neurotrophic factor (BDNF), and vascular endothelial growth factor (VEGF) are mediators of neuronal plasticity and neurogenesis. These neurotrophins are involved in sleep and sleep disorders and are associated with sleep deprivation. In this study, it is aimed to investigate the changes of neurotrophin levels with total sleep deprivation in healthy individuals. Seventeen healthy young adults with a mean age of 19.8 (SD = 1.0) years underwent an experimental protocol consisting of 36 h of total sleep deprivation. Venous blood samples were obtained on Day1 at 09.00, on Day2 at 09.00, and at 21.00. Serum levels of neurotrophins were detected using the ELISA method. The participants were asked to mark the scores corresponding to their subjective energy, happiness, depression, tension levels on the visual analog scale; and sleepiness level on the Epworth Sleepiness Scale; during the course of the study. As a result of 36 h of sleep deprivation, serum GDNF, BDNF, and VEGF levels showed a statistically significant increase compared to the baseline values in the participants included in the study (P < 0.0001). While this increase was evident in 24 h, it continued after 36 h. In parallel, sleepiness levels, subjective depression, and tension levels increased, on the other hand, subjective energy and happiness scores decreased at a statistically significant level at the end of the study compared to basal values (P < 0.0001). The results show that acute sleep deprivation significantly affects and increases serum levels of neurotrophic factors, and it seems that these effects are likely to occur as an immediate response to the stress and disruption caused by sleep deprivation.Öğe Acute stress disorder and post-traumatic stress disorder following traumatic amputation(Acta Medica Belgica, 2010) Copuroglu, Cem; Ozcan, Mert; Yilmaz, Baris; Gorgulu, Yasemin; Abay, Ercan; Yalniz, ErolTraumatic amputations are important causes of acute stress disorder and post-traumatic stress disorder. In this study, we aimed to rind out the occurrence rate of symptoms of acute and post-traumatic stress disorder after traumatic amputations and according to this, to assess the psychiatric status of the patients in the postoperative period. Twenty-two patients with traumatic limb amputation who were treated in our institution were retrospectively evaluated. During the early post-traumatic period, the patients were observed to determine whether they needed any psychiatric supportive treatment. During the follow-up period, after the sixth month from the trauma, the patients were referred to the psychiatry department and they were evaluated to determine whether they needed any psychiatric supportive treatment, by clinical psychiatric examination and use of the 'post-traumatic stress disorder scale' (Clinician Administered Post traumatic Scale, or CAPS). Twenty-one (95.5%) of 22 patients were male, one (4.5%.) female. Mean age of the patients was 40.8 years (range : 15 to 69). During the early post-traumatic period, 8 (36.3%) of these patients consulted the psychiatry clinic following the orthopaedists' observations. Five (%22.7) of these patients needed psychiatric supportive treatment for acute stress disorder. After the 6th month (6 months to 5 years), 17 (77.2%) had chronic and delayed post-traumatic stress disorder and needed psychiatric supportive treatment. Patients who have sustained a traumatic amputation may need psychiatric supportive treatment in the late period after the trauma. As we orthopaedic surgeons treat these patients surgically we should be aware of their psychiatric status.Öğe Alcohol and Psychoactive Substance Use among University Students in Edirne and Related Parameters(Aves, 2016) Gorgulu, Yasemin; Cakir, Digdem; Sonmez, Mehmet Bulent; Kose Cinar, Rugul; Vardar, Mehmet ErdalIntroduction: Alcohol and psychoactive substance use and their effects are an important issue among adolescents and young adults. Different results have been reported about the frequency of alcohol and psychoactive substance use among university students in studies conducted both in Turkey and in different places worldwide. Methods: The frequency of alcohol and psychoactive substance use among Trakya University students (n=1385) and the related parameters were studied cross-sectionally using a self-reporting questionnaire. Results: Alcohol was the most common substance used (30%), followed by tobacco (29.9%) and marijuana (3.1%). The frequency of alcohol and psychoactive substance use was found to be higher among males with higher amounts of pocket money, whose parents experienced more conflict in their relationship, and who belong to families with a higher education and income level. Conclusion: The frequency of alcohol and psychoactive substance use among Trakya University students was found to be lower than other regions in Turkey and particularly lower than the levels reported in studies conducted in other countries.Öğe Alterations of BDNF and GDNF serum levels in alcohol-addicted patients during alcohol withdrawal(European Journal Of Psychiatry, 2016) Sonmez, Mehmet Bulent; Gorgulu, Yasemin; Cinar, Rugul Kose; Kilic, Evnur Kahyaci; Unal, Aycan; Vardar, Mehmet ErdalBackground and Objectives: Brain-derived neurotrophic factor (BDNF) and glial cell line-derived neurotrophic factor (GDNF) are neurotrophic neuropeptides that play important roles in the synaptic plasticity, neuronal growth, survival and function. A possible neuroprotective role of neurotrophic factors against alcohol-induced cell damage has been suggested, and dysregulations in neurotrophic factors may be involved in the vulnerability to addiction. The aim of this study was to investigate the alterations of BDNF and GDNF serum levels in alcohol-addicted patients during alcohol withdrawal compared to healthy controls. Methods: BDNF and GDNF serum levels of 34 male inpatients diagnosed with alcohol addiction according to DSM-IV-TR were investigated during alcohol withdrawal (day 1, 7 and 14) in comparison to 32 healthy controls using an enzyme-linked immunosorbent assay (ELISA). Severity of alcohol withdrawal was measured by Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar), and intensity of alcohol craving was measured by Penn Alcohol Craving Scale (PACS) during alcohol withdrawal (day 1, 7 and 14). Results: BDNF serum levels increased significantly during alcohol withdrawal (p = 0.020). They were negatively correlated to the severity of alcohol withdrawal, and the correlation was close to being statistically significant (p = 0.058). BDNF and GDNF serum levels did not differ significantly between the patient and control groups. GDNF serum levels did not change significantly during alcohol withdrawal. Conclusions: Our results may provide support for the previously hypothesized role of BDNF in the neuroadaptation during alcohol withdrawal.Öğe Assessment of cytokine levels and hs-CRP in bipolar I disorder before and after treatment(Elsevier Ireland Ltd, 2015) Uyanik, Vesile; Tuglu, Cengiz; Gorgulu, Yasemin; Kunduracilar, Hakan; Uyanik, Mehmet SevkiWe aimed to assess the relationship between cytokine levels and the severity of the manic period in medication free patients. 30 Medication free patients and 28 healthy subjects (HS) were recruited. Plasma levels of pro-inflammatory, anti-inflammatory, inflammatory cytokines, and hs-CRP levels were investigated upon hospital admission, after six weeks follow up in bipolar disease manic episode and the results were compared to HS. The severity of the manic episodes was assessed according to the Young mania rating scale. TNF-alpha, INF-gamma, IL-6 and hs-CRP levels were significantly higher in patients with manic episode of bipolar I disorder before treatment than HS. After treatment the levels of TNF-alpha, INF-gamma, IL-6 and hs-CRP were observed to be significantly decreased. There was no difference between the levels of anti-inflammatory cytokines in patients before or after treatment of bipolar disorder and HS. hs-CRP was observed to be the only parameter correlated with clinical response. The most significant outcome of this study is the correlation between clinical outcome and hs-CRP levels in treatment naive manic episode bipolar type I patients. hs-CRP is the most consistent indicator according to pro-inflammatory, inflammatory and anti-inflammatory cytokines, in predicting treatment outcomes. (C) 2015 Elsevier Ireland Ltd. All rights reserved.Öğe Comparison of serum BDNF, IL-1?, IL-6, TNF-?, CRP and leucocyte levels in unipolar mania and bipolar disorder(Cambridge Univ Press, 2021) Gorgulu, Yasemin; Uluturk, Milkibar Kyazim; Palabiyik, OrkideObjective: Unipolar mania is not included in the diagnostic and statistical manual of mental disorders-5 (DSM-5) as a separate diagnosis, although it is defined by widely accepted diagnostic criteria. The aim of this study was to investigate the differences between unipolar mania and bipolar disorder in terms of clinical and inflammatory parameters. Methods: The data of 495 hospitalised patients with bipolar disorder diagnoses were analysed retrospectively. Forty met the diagnostic criteria for unipolar mania. Two patients refused to participate in the study. Thirty-eight unipolar mania patients and 42 randomly selected patients with bipolar disorder diagnosis were included in the study. The two groups were compared in terms of sociodemographic, clinical characteristics, serum brain-derived neurotrophic factor, C-reactive protein (CRP), leucocyte and cytokine levels. Results: A total of 40 (8.08%) of 495 patients diagnosed with bipolar disorder met the unipolar mania diagnostic criteria. The number of manic episodes and the number of hospitalisations were statistically higher in the unipolar mania group than in the bipolar disorder group. Among all the manic symptoms, the incidence of symptoms such as euphoria, increased sexual interest, grandiosity and delusions were found to be statistically higher in the unipolar mania group. Interleukin (IL)-6 and CRP levels were significantly higher in the unipolar mania group than in the bipolar disorder group. Conclusion: Unipolar mania differs from bipolar disorder in terms of clinical features and serum IL-6 and CRP levels.Öğe Could serum endocannabinoid and N-acylethanolamine levels be important in bipolar disorder?(Taylor & Francis Ltd, 2023) Topuz, Ruhan Deniz; Gorgulu, Yasemin; Uluturk, Milkibar KyazimObjectives The endocannabinoid system (ECS) is a critical important neuromodulatory system that interacts with many neurohormonal and neurotransmitter systems in the brain. It plays a pivotal role in emotional responses and mood regulation. The ECS is related with psychotic disorders, depression, anxiety and autism. In this study, we aimed to investigate whether there is any relationship between endocannabinoid and N-acylethanolamine levels with bipolar disorder. Methods Seventy-nine patients with bipolar disorder diagnosis, who are in the euthymic period, were included in the study. Clinical characteristics, symptoms and serum endocannabinoid and N-acylethanolamine levels were compared. Endocannabinoid and N-acylethanolamine levels were evaluated using liquid chromatography-tandem mass spectrometry. Results In total of 79 patients, 44 (55.69%) were females and 35 (44.30%) were males. The mean age of the patients was 42.40 +/- 1.10 years. Palmitoylethanolamide (PEA) levels were higher and oleoylethanolamide and 2-arachidonyl glycerol levels were lower in patients who had at least one depressive episode during their life-time illness than in patients who had no depressive episode while arachidonyl ethanolamide levels were unchanged Conclusions PEA levels were correlated with the history and frequency of depressive episodes and the history of depressive symptoms in patients with bipolar disorder.Öğe Decreased interoceptive awareness in patients with substance use disorders(Taylor & Francis Inc, 2017) Sonmez, Mehmet Bulent; Kilic, Evnur Kahyaci; Col, Isil Ates; Gorgulu, Yasemin; Cinar, Rugul KoseIntroduction: The current study was prepared based on the assumption that awareness of the interoceptive processes may be disturbed in addicted individuals, Methods: The participants in the study included 84 abstinent male inpatients who were addicted to alcohol (n = 33), heroin (n = 29), or synthetic cannabinoids (n = 22) according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), and 35 healthy male volunteers. Interoceptive awareness (IA) was measured using the heartbeat perception (HBP) task. Addiction severity was assessed using the addiction profile index (API). Alexithymia was assessed using the Toronto alexithymia scale (TAS-20). Results: Patients addicted to alcohol, heroin, or synthetic cannabinoids had similar IA, and their HBP scores were significantly lower than those of healthy control subjects. There was a significant negative correlation between HBP scores and TAS-20 subscores, thus indicating difficulties in identifying feelings. HBP scores were not significantly correlated with API scores. API scores were significantly correlated with total alexithymia scores and subscores, thus indicating difficulties in identifying and describing feelings. Discussion: As our main finding, a decrease in IA in addicted patients in comparison to healthy controls may provide support for the hypothesis that awareness of the interoceptive processes may be disturbed in addiction.Öğe The effect of subthreshold depressive symptoms on cognitive functions and peripheral biomarkers in bipolar disorder(Taylor & Francis Ltd, 2023) Sogut, Kubra; Gorgulu, Yasemin; Palabiyik, OrkideObjective: A global approach to factors responsible for functional impairment in patients with BD is necessary.Method: Ninety-three euthymic patients with BD [49 patients with SD (subthreshold depression) and 44 patients without SD] and 48 healthy controls were invited for evaluation of demographic, clinical, and cognitive characteristics. To define SD, the lower limit was HDRS =4 points and the upper limit was HDRS <9 points. Stroop test, California verbal learning test, digit-span test, controlled word association test, and clock drawing test were performed. Serum BDNF levels were measured. Additionally in the BD group; blood drug (lithium, valproic acid), leukocyte, C-reactive protein (CRP), TSH, and vitamin B12 levels were measured.Results: We found no difference between serum BDNF levels of BD (n = 93) and controls. The cognitive performances of the BD group were worse than the control group (p < 0.001). Attention, working memory, and stroop performance of patients with SD were worse than patients without SD (p < 0.05). Verbal fluency, stroop test, and planning performance decreased as serum CRP level increased in patients with BD (p < 0.05).Conclusions: Although the patient group with SD was in euthymia, their cognitive performance was worse than the group without SD. Poor cognitive performance in BD was associated with serum CRP levels.Öğe The effects of indwelling voice prosthesis on the quality of life, depressive symptoms, and self-esteem in patients with total laryngectomy(Springer, 2015) Polat, Beldan; Orhan, Kadir Serkan; Kesimli, Mustafa Caner; Gorgulu, Yasemin; Ulusan, Murat; Deger, KemalThis study aims to evaluate the effects of voice rehabilitation with indwelling voice prosthesis on quality of life, depression, anxiety, self-esteem, and sexual functions in laryngectomy patients. Provox-1 (TM) was applied to 30 patients who underwent total laryngectomy by opening a tracheoesophageal fistula. WHO Quality of Life-BREF, Beck Depression Inventory, Beck Anxiety Inventory, Rosenberg Self-Esteem Scale, Arizona Sexual Experience Scale forms were asked to be filled out by the patients before voice prosthesis application. These tests were asked to be filled out again 3 months later after the voice prosthesis application. Paired samples and Wilcoxon tests were used to compare before and after operation values. Indwelling voice prosthesis was found to improve quality of life, self-esteem, and sexual function (p < 0.05). Additionally, symptoms of depression and anxiety were regressed (p < 0.05). Indwelling voice prosthesis was found to especially increase the quality of life and decrease depression (p < 0.05). This study is an uncontrolled single-arm study comparing patients' psychosocial statuses pre- and post-voice prosthesis.Öğe Effects of Selective Serotonin Reuptake Inhibitors on Macular Ganglion Cell Complex Thickness and Peripapillary Retinal Nerve Fiber Layer Thickness(Taylor & Francis Inc, 2018) Guclu, Hande; Gorgulu, Yasemin; Gurlu, Vuslat Pelitli; Cinar, Rugul Kose; Ozal, Sadik Altan; Caliyurt, OkanPurpose: To evaluate macular ganglion cell complex (GCC) thickness and peripapillary retinal nerve fiber layer (RNFL) thickness in patients treated with SSRIs.Methods: The present study included 62 eyes of 31 patients who were using SSRIs and 60 eyes of 30 healthy, age- and gender-matched control subjects. All patients underwent a full ophthalmological examination in which macular thickness, GCC thickness, and peripapillary RNFL thickness were measured using optical coherence tomography (OCT). The Mann-Whitney U test was used to compare the patients' group with the age- and gender-matched control group. Pearson correlation analyses were also performed to assess the relationships between macular thickness, GCC thickness, RNFL thickness, and the duration of SSRI usage.Results: The mean duration of SSRI usage was 29.9627.19 (range 6-120) months. The foveal thickness was 253.48 +/- 22.77 mu m in the patients' group and 266.60 +/- 20.64 mu m in the control group; the difference between the groups was statistically significant. In addition, the perifoveal GCC thickness in the inferonasal and inferotemporal quadrant were significantly smaller thinner in the patient group (Mann-Whitney U test, p=0.021and p=0.013, respectively).Conclusions: Our results suggest a relation between SSRIs and decreased retinal GCC thickness and RNFL thickness. Future long-term prospective studies should elucidate the actual effect of SSRIs on GCC and RNFL thickness.Öğe Evaluating the people who were sent for determining of criminal responsibility(Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2015) Gorgulu, Yasemin; Kucuk, Aylin; Cetinkaya, Secil UysalObjective: According to the penal code in Turkey, a person who, during the commission of a crime, is under the influence of mental illness, who cannot detect legal meaning and consequences of the act committed or whose ability to redirect his/her behavior in relation to the act decreased significantly, will not be punished. The purpose of this study is to evaluate socioeconomic data on people who were sent for criminal responsibility evaluation to the largest forensic psychiatry clinic of Turkey during one-year period, the expert opinion on criminal responsibility, the diagnostic distributions, and the nature of their crimes. Methods: The medical files of 332 people were examined retrospectively. Results: It has been determined that 54.5% had a full criminal responsibility since it was detected that they had no mental illness or weakness which might affect their criminal responsibility and 39.5% were found to have no criminal responsibility for having a psychiatric disorder on the date of crime. Discussion: Considering the fact that those who were sent for psychiatric evaluation after committing a crime have psychiatric disorders as well as the distribution of psychiatric disorder diagnoses, the nature of the crimes committed and against whom these crimes were committed, results of the studies in our country and abroad were found to be compatible and consistent.Öğe Evaluation of phosphatidylethanol by ELISA for detection of excessive alcohol use compared with traditional biomarkers: a case-control study(Taylor & Francis Ltd, 2017) Sonmez, Mehmet Bulent; Cinar, Rugul Kose; Gorgulu, Yasemin; Kilic, Evnur Kahyaci; Unal, AycanObjective: The highly sensitive chromatographic methods for quantifying phosphatidylethanol (PEth) require high levels of expertice and expensive instrumentation. Enzyme-linked immunosorbent assay (ELISA) kits have been developed for research purposes, but the implementation of PEth immunoassays to screen alcohol consumption has not been applied to the analysis of clinical samples. Our aim was to examine the ELISA method for PEth analysis in clinical samples. Methods: We examined the alterations of the PEth serum levels of 22 male inpatients diagnosed with alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, during alcohol withdrawal (at days 1, 7, and 14) compared to 32 healthy controls using ELISA. All patients were admitted for detoxification treatment at the Alcohol and Substance Addiction Treatment and Rehabilitation Center, Trakya University School of Medicine, Edirne, Turkey. Control subjects were assessed with an initial clinical interview and screened with the Alcohol Use Disorder Identification Test (AUDIT), and they included 16 nondrinkers (AUDIT score = 0) and 16 social drinkers (AUDIT score < 8). We examined the diagnostic accuracy of PEth compared to the traditional biomarkers according to the receiver operating characteristic curve analysis. Results: The patients undergoing detoxification had higher baseline PEth levels than the nondrinkers and social drinkers; the difference between groups showed a marginal trend towards significance (p = 0.052). PEth was correlated with the self-reported drinking amount in the past month and AUDIT scores, and the correlations showed marginal trends towards significance (r(s) = 0.269, p = 0.049; and rs = 0.266, p = 0.052; respectively). The PEth levels were statistically significantly correlated with gamma-glutamyl transferase (GGT) (r(s) = 0.355, p = 0.010), the correlations with alanine aminotransferase (ALT) and aspartate aminotransferase (AST) trended towards statistical significance (r(s) = 0.230, p = 0.095; and r(s) = 0.261, p = 0.056, respectively), and PEth was not statistically significantly correlated with mean corpuscular volume (MCV) (r(s) = 0.100, p = 0.478). PEth levels decreased statistically significantly during alcohol withdrawal (p = 0.002). PEth levels of the nondrinkers and social drinkers did not differ statistically significantly (p = 1.000). The area under the curve (AUC) for PEth measured by ELISA was statistically significantly higher than 0.5 (AUC = 0.691, p = 0.024), but PEth had poorer diagnostic efficacy than GGT (AUC = 0.933, p < 0.001), AST (AUC = 0.931, p < 0.001), MCV (AUC = 0.803, p < 0.001), and ALT (AUC = 0.789, p < 0.01). Conclusions: The AUC of 0.69 shows that the diagnostic accuracy of the assay was poor, regardless of a statistical comparison to 0.5. The use of serum might have led to low concentrations that have not differed much between heavy drinkers and social drinkers or abstainers. Whole blood ELISA implementation for the quantification of PEth may increase its diagnostic efficacy.Öğe Idiopathic Bilateral Basal Ganglia Calcification (Fahr's Disease) Presenting with Psychotic Depression and Criminal Violence: A Case Report With Forensic Aspect(Turkiye Sinir Ve Ruh Sagligi Dernegi, 2014) Ozer, Urun; Gorgulu, Yasemin; Can Gungor, Ferda; Gencturk, MertFahr's disease is a rare neuropsychiatric disease characterized by bilateral intracranial calcification, primarily in the basal ganglia. The more general term, Fahr's syndrome, is used for primary and secondary basal ganglia calcification, regardless of the etiology, but the term Fahr's disease is used to describe primary, idiopathic cases. Fahr's disease may present with neurological symptoms, such as parkinsonism and extrapyramidal symptoms, dysarthria, paresis, convulsion, and syncope. Psychiatric disorders, including behavioral disorders, psychosis, and mood disorders, as well as cognitive disorders can occur. CT is useful for the diagnosis of Fahr's disease. Herein we present a patient diagnosed as Fahr's disease that presented with symptoms of depression, delusions, and auditory hallucinations. The 47-year-old male patient was hospitalized in a forensic psychiatry inpatient clinic due to aggressive behavior and was subsequently diagnosed with major depressive disorder with psychotic features. While hospitalized he was treated with antidepressant and antipsychotic drugs, as well as electroconvulsive therapy, resulting in significant improvement in his symptoms. As bilateral basal ganglia calcification was observed via CT, the patient was diagnosed as Fahr's disease. This case report emphasizes the importance of cranial imaging and detailed laboratory examination when evaluating patients with psychosis and affective symptoms. Pathologies such as Fahr's disease must be included in the differential diagnosis, especially in cases with neurological symptoms and cranial imaging findings.Öğe Impact of Experiencing Acute Coronary Syndrome Prior to Open Heart Surgery on Psychiatric Status(Soc Brasil Cirurgia Cardiovasc, 2016) Yuksel, Volkan; Gorgulu, Yasemin; Cinar, Rugul Kose; Huseyin, Serhat; Sonmez, Mehmet Bulent; Canbaz, SuatObjective: The incidence of depression and anxiety is higher in patients with acute coronary syndrome. The aim of this study is to determine whether experiencing acute coronary syndrome prior to open heart surgery affects patients in terms of depression, hopelessness, anxiety, fear of death and quality of life. Methods: The study included 63 patients who underwent coronary bypass surgery between January 2015 and January 2016. The patients were divided into two groups: those diagnosed after acute coronary syndrome (Group 1) and those diagnosed without acute coronary syndrome (Group 2). Beck depression scale, Beck hopelessness scale, Templer death anxiety scale and death depression scale, State-Trait anxiety inventory and WHOQOL-Bref quality of life scale were applied. Results: There was no significant difference between the two groups in terms of the total score obtained from Beck depression scale, Beck hopelessness scale - future-related emotions, loss of motivation, future-related expectations subgroups, death anxiety scale, the death depression scale, State-Trait Anxiety Inventory social and environmental subgroups. The mental quality of life sub-scores of group 2 were significantly higher. The patients in both groups were found to be depressed and hopeless about the future. Anxiety levels were found to be significantly higher in all of the patients in both groups. Conclusion: Acute coronary syndrome before coronary artery bypass surgery impairs more the quality of life in mental terms. But unexpectedly there are no differences in terms of depression, hopelessness, anxiety and fear of death.Öğe The impact of preoperative psychological characteristics on postoperative satisfaction and quality of life in patients undergoing septoplasty and inferior turbinate ablation surgery(Springer, 2022) Guven, Selis Gulseven; Gorgulu, YaseminPurpose To investigate the effect of preoperative mental state on postoperative satisfaction and quality of life in patients undergoing septoplasty and inferior turbinate ablation surgery. Methods A total of 41 patients who underwent septoplasty and inferior turbinate ablation surgery due to nasal congestion were included in the study. Patients were asked to complete the Mental Symptoms Checklist Revised (SCL-90 R), World Health Organization Quality of Life Scale-Short Form (WHOQoL-BREF-TR), and Visual Analogue Scale (VAS) tests before and after their surgery. The surgical procedure for all patients was performed by a single ear-nose-throat physician. The preoperative and postoperative test results were then compared. Results A significant decrease was noted in the postoperative SCL-90 R somatization (p < 0.001), additional items (p = 0.001), and global severity index (GSI) (p = 0.002) scores; a significant increase was observed in the postoperative WHOQoL-BREF-TR physical health score (p = 0.029); and a significant decrease was seen in the postoperative VAS scores (p < 0.001). The preoperative SCL-90 R GSI showed a negative correlation with the postoperative WHOQoL-BREF-TR total score and a significant positive correlation with the postoperative VAS scores (p < 0.05 for all). There was a significant difference between those with a postoperative VAS score of <= 2 and > 2 in terms of GSI and all preoperative SCL-90 R subscale scores, except for the additional items subscale. Increased preoperative psychological symptoms reported by the patients were associated with a lower perception of postoperative quality of life. Conclusion The preoperative mental state of patients undergoing septoplasty and inferior turbinate ablation surgery affects postoperative satisfaction and quality of life. In addition, the recognition of this parameter may contribute to the treatment management of these patients and the legal protection of physicians.Öğe Late-onset clozapine-induced neutropenia treated with lithium(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2019) Durmus, Pelin Tas; Gorgulu, Yasemin; Sonmez, Mehmet Bulent; Cinar, Rugul KoseClozapine is a second-generation antipsychotic drug, proven to be effective in treatment-resistant schizophrenia. Among patients using clozapine; the incidence of neutropenia is approximately 3% and the incidence of agranulocytosis is approximately 1%. This side effect is diminishing after 18 weeks of drug initiation. Here, we present a case of clozapine-induced neutropenia in a schizophrenic patient seen after 7 years of clozapine use and its treatment with lithium supplementation.Öğe Manic Shift Due to the Use of Bupropion in Bipolar Depression: Two Case Reports(Turkiye Sinir Ve Ruh Sagligi Dernegi, 2019) Kahyaci Kilic, Evnur; Gorgulu, Yasemin; Kose Cinar, Rugul; Bulent Sonmez, MehmetBupropion is a selective norepinephrine and dopamine reuptake inhibitor. It is used in the treatment of depression and nicotine addiction. When compared to the other antidepressants, bupropion has a relatively lower risk of triggering shift to hypomania or mania in bipolar depression treatment. Here we report two cases of bipolar depression patients with manic shift when bupropion was used as an adjunct to mood stabilizer treatment. The first was a 43-year old female patient. Manic symptoms occurred after bupropion was added to lithium and quetiapine treatment for bipolar disorder (BD) depressive episode. Her manic symptoms regressed rapidly after discontinuing bupropion treatment. The second patient was a 26-year old male on lithium and valproate therapy with a BD diagnosis. After bupropion was added to his treatment for depressive symptoms, psychotic mania ensued and he had to be admitted to the hospital. Significant improvement was noted shortly after bupropion was discontinued and antipsychotic treatment was initiated.Öğe Peripheral blood mRNA expressions of stress biomarkers in manic episode and subsequent remission(Pergamon-Elsevier Science Ltd, 2016) Cinar, Rugul Kose; Sonmez, Mehmet Bulent; Gorgulu, YaseminTheoretical models of the neuroprogressive nature of bipolar disorder (BD) are based on the hypothesis that it is an accelerated aging disease, with the allostatic load playing a major role. Glucocorticoids, oxidative stress markers, inflammatory cytokines and neurotrophins play important roles in BD. The messenger ribonucleic acid (mRNA) expressions of brain-derived neurotrophic factor (BDNF), tissue plasminogen activator (tPA), glucocorticoid receptor (GR), heat shock protein 70 (HSP70), tumour necrosis factor alpha (TNF-alpha) were examined in the peripheral blood of 20 adult male, drug-free BD patients during manic and remission periods and in 20 adult male, healthy controls. mRNA expression was measured using the quantitative real-time polymerase chain reaction (qRT-PCR). Compared to the controls, the expressions of BDNF and tPA mRNA were down-regulated in mania. In remission, BNDF and tPA mRNA levels increased, but they were still lower than those of the controls. Between mania and remission periods, only the change in mRNA levels of BDNF reached statistical significance. The results suggest that BDNF and tPA may be biomarkers of BD and that proteolytic conversion of BDNF may be important in the pathophysiology of BD. The change in BDNF levels between mania and remission could be adaptive and used to follow the progression of BD. (C) 2016 Elsevier Ltd. All rights reserved.Öğe The prevalance of separation anxiety disorder in patients with generalised anxiety disorder who applied to an university hospital outpatient clinic(Klinik Psikiyatri Dergisi, 2020) Demir, Nevlin Ozkan; Gorgulu, YaseminObjective: Separation anxiety disorder (SAD) is mostly known as a psychiatric disorder of childhood. However SAD has been redefined in DSM-5 and thus, it has became possible to diagnose SAD in adulthood as well. The aim of our study is to determine the prevelance of SAD among adult patients with generalised anxiety disorder, also to investigate the symptoms of separation anxiety in childhood and to examine its reflections on the separation anxiety symptoms of adulthood. Method: 50 adult patients with generalised anxiety disorder (GAD) who were admitted to the psychiatry outpatient clinic of Trakya University Hospital were included in this study. The presence of psychiatric disorders was determined according to the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS) and Adult Separation Anxiety Questionnaire (ASA) were applied to assess the symptoms of separation anxiety. Sociodemographic factors and reports of early separation anxiety (Separation Anxiety Symptom Inventory, SASI) and a retrospective diagnosis of separation anxiety disorder among childhood were also measured. Results: According to our results the prevalance of SAD in patients with GAD was 45,2% and SAD was more common among females (p=0,02). Patients with SAD had elevated early separation anxiety scores. Furthermore, a statistically significant positive correlation was found between childhood SASI and ASA scores (r=0,71, p=0,00). Discussion: Our results show that separation anxiety is highly prevalant among GAD patients. Early separation anxiety scores are positively correlated with adult separation anxiety scores. However, in order to determine the effects of chilhood separation anxiety symptoms on adulthood, large sample sizes and prospective studies are needed.
