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Öğe Adult attention-deficit hyperactivity disorder in patients with bipolar I disorder in remission: Preliminary study(Blackwell Publishing, 2006) Tamam, Lut; Tuglu, Cengiz; Karatas, Gonca; Ozcan, SevilayAttention-deficit hyperactivity disorder (ADHD), a syndrome that typically first appears in early childhood, can occur in individuals of all ages. Prospective studies have demonstrated that at least half of children diagnosed as having ADHD continue to suffer the symptoms of this disorder in their adult life with significant impacts on their social status, achievement level and sense of well-being. The purpose of this preliminary study was to determine the rate of ADHD in patients with bipolar disorder (BD) and to examine the effects of comorbid ADHD on several clinical and sociodemographic variables of bipolar patients. Forty-four BD-I patients followed up in psychiatric outpatient clinics in two university hospitals, were assessed for the presence of adult ADHD according to DSM-IV. All patients also completed the Wender Utah Rating Scale for objective evaluation of ADHD. Of 44 patients with BD-I, only seven (15.9%) fulfilled criteria for a diagnosis of adult ADHD. Bipolar disorder-I patients with comorbid ADHD were more likely to be female, and have more affective episodes (especially depressive episodes) than bipolar patients without comorbid ADHD. Age at onset of affective illness was not significantly different between the two groups. In line with results of several previous reports, the present study also showed higher prevalence of ADHD in patients with BD-I than in normal population. A higher number of affective episode in patients with comorbid ADHD may suggest a more severe clinical course of BD in these patients. A larger group of samples is required to clarify the exact association and interaction between these two clinical entities.Öğe Antipsychotics for the treatment of bipolar disorder(Kure Iletisim Grubu A S, 2008) Tuglu, CengizAntipsychotics are commonly used in bipolar disorders both for the treatment of acute episodes and of maintenance. However, the use of typical antipsychotics in bipolar episodes is associated with a number of limitations. Most of the second generation antipsychotics have been found effective in manic states. In this article, recent literature has been reviewed to show the potential use and benefits of the antipsychotics especially second generation ones in patients suffering form mania or depression.Öğe Are antidepressants addictive? A case with tianeptine misuse(Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2010) Tuglu, Cengiz; Sahin, Oezlem OeztuerkTianeptine is a dibenzothiazepine type an atypical, tricyclic antidepressant. Biochemically it has been shown that after single or repeated administration, tianeptine increases the presinaptic reuptake of serotonine at the brain and trombocytes. Tianeptine reduces the hypothalamic-pituitary-adrenal response to stress and antogonizes the behavoiral problems induced by stress. Its pharmacotherapotic effects are neither stimulant nor sedative. Addiction to antidepressant therapy is controversial and rarely defined at the literature. Here we represent the tolerance, withdrawal symptoms and treatment issues of the case whom misused tianeptine at extremly high doses. (Anatolian Journal of Psychiatry 2010; 11:190-193)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 The relation of homocysteine levels with deficit syndrome and working memory in schizophrenic patients(Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2011) Tuglu, Cengiz; Ozcan, Sevilay; Erdogan, Yasin; Sut, Nejdet; Vardar, Erdal; Abay, ErcanObjective: There are many theories about etiology of schizophrenia and many studies are going on to find out a biologic determinant specific for schizophrenia. Single carbon metabolism theory has been suggested for the etiology of schizophrenia. There are also many data about a defect in homocysteine metabolism and increased levels of homocysteine in schizophrenic subjects but the correlation of hyperhomocysteinemia with the clinical reflections and symptom dispersion of schizophrenia has not been studied yet. Methods: For forty-one schizophrenic patients, clinical assessments were performed. The patients were divided into two groups, as deficit syndrome group and nondeficit syndrome group, using the deficit syndrome chart. Various test batteries have been applied to all patients to asses the clinical symptomatology and working memory. Serum homocysteine, vitamin B-12, and folic acid levels were measured concurrently. Results: Homocysteine levels were higher in the study group and mild to moderate hyperhomocysteinemia has been observed at the sample group independent folic acid levels. The homocysteine levels and clinical scale scores did not correlate statistically but folic acid levels did with negative symptomotology and functional disturbance. Conclusion: Serum homocysteine levels were elevated in both male and female schizophrenia patients. Hyperhomocysteinemia with the deficit syndrome as well as working memory did not show a statistically significant correlation. (Anatolian Journal of Psychiatry 2011; 12:169-176)Öğe The relationship between metabolic syndrome and impulsivity in patients with bipolar disorder(Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2020) Ozkan Demir, Nevlin; Tuglu, CengizObjective: Metabolic syndrome (MetS) is highly prevalent in people with bipolar disorder (BD), comparing to the general population. There are many risk factors effecting the development of MetS. Impulsivity has been shown to increase MetS parameters such as obesity and blood pressure indirectly in various studies. This study is based on the hypothesis that higher impulsivity may be observed in BB patients with comorbid MetS. The aim of this study is to draw attention to MetS, which is quite common in patients with BD, to examine the relationship between impulsivity and MetS by considering other possible related parameters and to contribute to the literature knowledge in this field. Methods: This study analyzed 125 bipolar patients in remission at psychiatry outpatient clinic of Trakya University Hospital. MetS parameters of patients were evaluated according to American National Cholesterol Education Program Third Adult Treatment Panel criteria. The Structured Clinical Interview, Young-Mania Rating Scale, Hamilton Depression Rating Scale, Barratt Impulsivity Scale-11 (BDI-11), Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire, the International Physical Activity Questionnaire were applied to the patients. Results: The prevalence of metabolic syndrome in bipolar patients was 56% in our hospital. A backward stepwise logistic regression model showed that the total score of the BDI-11 (OR=1,192, 95% confidence interval 1.006-1.412, p=0.042) and daily sitting time of patients (OR=1.073, 95% CI 1.021-1.128, p=0.005) was significantly higher in bipolar patients with metabolic syndrome. Discussion: According to the results of our study, the prevalence of MetS is common in patients with BD and patients with BD who have higher impulsivity and sedentary life style have higher risk of metabolic syndrome.Öğe The Role of Serum Cytokines in the Pathogenesis of Hepatic Osteodystrophy in Male Cirrhotic Patients(Hindawi Ltd, 2012) Soylu, Ali Riza; Tuglu, Cengiz; Arikan, Ender; Yetisyigit, Tarkan; Kunduracilar, Hakan; Koker, Ibrahim Hakki; Unsal, GulbinObjective. In this study, we aimed to investigate the possible role of serum cytokines in the development of hepatic osteodystrophy. Matherial and Methods. 44 consecutive male cirrhotic patients (17 alcoholic, 20 hepatitis B, 7 hepatitis C), 15 age- and sex-matched chronic alcoholics without liver disease, and 17 age- and sex-matched healthy controls were included in the study during one year period. Bone mineral density was measured by dual X-ray absorptiometry in the lumbar vertebrate and femoral neck. Serum interleukin levels were measured by ELISA method. Results. Although osteopenia frequency between our cirrhotic patients was 20%, there was no difference in T-scores among the controls and other groups. Serum interleukin-1, interleukin-8, and tumor necrosis factor-alpha levels were not different between all groups. Serum interleukin-2 and interleukin-6 levels were higher in the cirrhotics than controls (P < 0.001). However, there were no significant difference between osteopenic and nonosteopenic cirrhotics. Conclusion. According to the results of the study in this small population of 44 male cirrhotic patients, frequency of hepatic osteopenia is small and serum interleukins 1, 2, 6, 8, and tumor necrosis factor-alpha may not play a role in the pathogenesis of hepatic osteodystrophy. Further studies in which large number of patients involved are necessary in this field.
