$365 to mirtazapine does not result in a clinically relevant pharmacokinetic drug-drug interactio... more $365 to mirtazapine does not result in a clinically relevant pharmacokinetic drug-drug interaction. The combination was well tolerated and no major clinically relevant adverse events were observed Conclusion: Despite a limited number of patients the present data suggest that a combination of risperidone and mirtazapine does not necessitate a change of dose of either drug and is well tolerated •P300 amplitude is associated with genetic variations in the DRD3 dopamine receptor gene
Şizofreni Hastalarında Somatizasyonun Psikodinamik Anlamının Değerlendirilmesi Emine Müjgan ÖZEN,... more Şizofreni Hastalarında Somatizasyonun Psikodinamik Anlamının Değerlendirilmesi Emine Müjgan ÖZEN, Doğan YEŞİLBURSA, Ali BELENE, Ayşe SOLMAZ TÜRKCAN, Erdal ... Bu durum, bedenle ilgili ikili bir kavram oluşmasına yol açar; bedenin geçmişte kalan varlığı ve şu anki ...
Two four-marker haplotypes on 7q36.1 region indicate that the potassium channel gene HERG1 (KCNH2... more Two four-marker haplotypes on 7q36.1 region indicate that the potassium channel gene HERG1 (KCNH2, Kv11.1) is related to schizophrenia: a case control study
Two four-marker haplotypes on 7q36.1 region indicate that the potassium channel gene HERG1 (KCNH2... more Two four-marker haplotypes on 7q36.1 region indicate that the potassium channel gene HERG1 (KCNH2, Kv11.1) is related to schizophrenia: a case control study
Background: The pathobiology of schizophrenia is still unclear. Its current treatment mainly depe... more Background: The pathobiology of schizophrenia is still unclear. Its current treatment mainly depends on antipsychotic drugs. A leading adverse effect of these medications is the acquired long QT syndrome, which results from the blockade of cardiac HERG1 channels (human ether-a-go-go-related gene potassium channels 1) by antipsychotic agents. The HERG1 channel is encoded by HERG1 (KCNH2, Kv11.1) gene and is most highly expressed in heart and brain. Genetic variations in HERG1 predispose to acquired long QT syndrome. We hypothesized that the blockade of HERG1 channels by antipsychotics might also be significant for their therapeutic mode of action, indicating a novel mechanism in the pathogenesis of schizophrenia. Methods: We genotyped four single nucleotide polymorphisms (SNPs) in 7q36.1 region (two SNPs, rs1805123 and rs3800779, located on HERG1, and two SNPs, rs885684 and rs956642, at the 3'-downstream intergenic region) and then performed single SNP and haplotype association a...
Fetishism is defined as the recurrent and intense use of nonliving objects for sexual arousal and... more Fetishism is defined as the recurrent and intense use of nonliving objects for sexual arousal and gratification. Kleptomania is defined as a recurrent failure to resist impulses to steal objects not needed for personal use or their monetary value. Both fetishism and kleptomania cases are generally sent mandatory to psychiatric clinics by courts. In this paper, a 32-year old male patient, followed-up with a diagnosis of fetishism and kleptomania, and referred for psychiatric evaluation as a result of multiple stealing of the “fetish”, with multiple jail experience and some social losses is reported, and fetishism and kleptomania are discussed with regard to the biological and dynamic approaches and forensic psychiatry. (Archives of Neuropsychiatry 2009; 46: 125-8) Key words: Fetishism, paraphilia, kleptomania, forensic psychiatry
Somatization which is the somatic way of expressing emotional distress and unconscious conflicts ... more Somatization which is the somatic way of expressing emotional distress and unconscious conflicts instead of words, frequently accompanies schizophrenia as well as many other psychiatric disorders. Schizophrenia patients have a specific interest in bodily sensations. Libidinal energy which is withdrawn from objects is transferred to the body (soma) and the body remains to be the only real object to communicate with. It’s known that schizophrenia may start with somatic and hypochondriac symptoms, and that hypochondriac symptoms may also emerge during the recovery periods in schizophrenia. On the other hand our clinical observations indicate that schizophrenia patients present with somatic complaints in any phase of the disorder. The association of schizophrenia and somatization has not been studied much. However, schizophrenia patients expressing somatic complaints are common in clinical practice. This review aims to evaluate the meaning of somatization in schizophrenia, to assess the...
Introduction Schizophrenia (SCH) is one of the major and potentially severe mental illness that i... more Introduction Schizophrenia (SCH) is one of the major and potentially severe mental illness that is characterized by both genetic and clinical heterogeneity. Thyroid hormone plays an important role in the development of the brain and nervous system both in the basic process of neurogenesis and of terminal brain differentiation. Type II deiodinase (DIO2) enzyme which has a critical role on thyroid hormone metabolism to convert pro-hormone thyroxine (T4) to the active hormone triiodothyronine (T3). Recently, DIO2 gene variations have been identified in association with mental disorders. Methods To investigate the potential genetic contribution of the DIO2 gene to SCH, we studied DIO2 Thr92Ala (rs225014) and ORFa-Gly3Asp (rs12885300) polymorphisms in a Turkish cohort of 290 unrelated SCH patients and 198 healthy controls. All subjects were genotyped by Taqman SNP genotyping assays. Results Single marker analysis showed a positive association of SCH and rs225014. Particularly, Thr92Ala genotype frequency was significantly higher in patients with SCH than controls (p=0.045) and in male patients with SCH, both allele and genotype frequencies were significantly higher compared to male controls (p=0.03). Allele and genotype frequencies of ORFa- Gly3Asp polymorphism were no different within the study group. Conclusion These data show a potential role of DIO2 as a candidate gene for susceptibility to SCH and provide a strong evidence for a role of the DIO2 Thr92Ala allele and genotype in the etiopathogenesis of SCH with sexual difference.
Antipsychotic medications can induce metabolic abnormalities (weight gain) in schizophrenia (SCH)... more Antipsychotic medications can induce metabolic abnormalities (weight gain) in schizophrenia (SCH). Leptin receptor (LEPR), leptin (LEP) and peroxysome proliferator-activated receptor g2 (PPARg2) are the potential genetic determinants which might be liable of the metabolic dysregulation. The aim of this study was to evaluate the effect of LEP c.-2548G>A, LEPR p.Q223R polymorphisms and the impact of mRNA levels of LEP, LEPR, and PPARg2 along with the serum leptin levels on metabolic adversities in SCH patients (n=132) and controls (n=114). Methods: Metabolic profiles, LEP, LEPR gene polymorphisms and the gene expressions of LEP, LEPR and PPARg2 were studied in SCH patients and controls. Results: BMI, cholesterol and fasting glucose levels were higher in SCH patients compared to controls. LEP c.-2548 (GA+AA) genotypes were two fold lower in SCH patients versus controls (p< 0.05), and no significant difference was observed in LEPR p.Q223R genotypes. Interestingly, leptin serum levels were lower in SCH patients compared to controls (p< 0.05). Leptin, leptin receptor and PPARg2 gene expressions were found to be decreased in SCH patients compared to controls (p< 0.001, p< 0.001 and p 0.05, respectively). Conclusion: Leptin receptor, leptin and PPARg2 genes could be potential risk factors in developing metabolic adversities in SCH.
Schizophrenia is a chronic illness with great economic burden. Paliperidone ER is a new atypical ... more Schizophrenia is a chronic illness with great economic burden. Paliperidone ER is a new atypical antipsychotic drug in Turkey. The aim of the study is to estimate the costeffectiveness of paliperidone ER compared to other oral atypicals (risperidone, olanzapine, quetiapine, ziprasidone and aripiprazole) in acute phase of schizophrenia. METHODS: Model: An existing decision analytic model is adapted (based on literature and expert panels). The time horizon is six weeks. The study is performed from the health care payer perspective. Patient group: Patients diagnosed with schizophrenia that have suffered an acute exacerbation. Data sources: The clinical data are acquired from the literature. Resource use data are derived via expert panel. Prices of medications, institutional discount rates and other costs related to the treatment are obtained from
Schizophrenia is a chronic illness with great economic burden. Paliperidone ER is a new atypical ... more Schizophrenia is a chronic illness with great economic burden. Paliperidone ER is a new atypical antipsychotic drug in Turkey. The aim of the study is to estimate the costeffectiveness of paliperidone ER compared to other oral atypicals (risperidone, olanzapine, quetiapine, ziprasidone and aripiprazole) in acute phase of schizophrenia. METHODS: Model: An existing decision analytic model is adapted (based on literature and expert panels). The time horizon is six weeks. The study is performed from the health care payer perspective. Patient group: Patients diagnosed with schizophrenia that have suffered an acute exacerbation. Data sources: The clinical data are acquired from the literature. Resource use data are derived via expert panel. Prices of medications, institutional discount rates and other costs related to the treatment are obtained from
Fetishism is defined as the recurrent and intense use of nonliving objects for sexual arousal and... more Fetishism is defined as the recurrent and intense use of nonliving objects for sexual arousal and gratification. Kleptomania is defined as a recurrent failure to resist impulses to steal objects not needed for personal use or their monetary value. Both fetishism and kleptomania cases are generally sent mandatory to psychiatric clinics by courts. In this paper, a 32-year old male patient, followed-up with a diagnosis of fetishism and kleptomania, and referred for psychiatric evaluation as a result of multiple stealing of the "fetish", with multiple jail experience and some social losses is reported, and fetishism and kleptomania are discussed with regard to the biological and dynamic approaches and forensic psychiatry.
Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 2010
Genel olarak emosyonel disforiyi bedensel belirtilerle ifade etme eğilimi olarak tanımlanan somat... more Genel olarak emosyonel disforiyi bedensel belirtilerle ifade etme eğilimi olarak tanımlanan somatizasyonda, "bedensel bir hastalıkla açıklanamayan fiziksel yakınmalar" mevcuttur ve kişi bu yakınmalarını bedensel bir hastalığa atfederek tıbbi yardım arayışına girer. Somatizasyon (bedenselleştirme) davranışı çeşitli psikiyatrik bozukluklarla ilişkilendirilmekle birlikte, en sık olarak depresyon ve anksiyete bozukluklarına eşlik ettiği bilinmektedir. Anksiyete bozuklukları ve majör depresyon vakalarında, somatik belirtilerin somatize edilmiş disforiyi yansıttığı düşünülmektedir. Psikiyatri ve genel tıp sınırında hala çözülememiş bir sorunun temsilcisi olan somatizasyon, hastaların yaşadıkları sıkıntı ve huzursuzluğu arttırmakta, hastalıkların gidişatını kötüleştirmekte ve yeti yitimini arttırmaktadır. Diğer yandan somatizasyon, depresyon ve anksiyete belirtilerini maskeleyerek doğru tanı koymayı güçleştirebilmekte ve tedavinin gecikmesine neden olabilmektedir. Bu sistematik olmayan gözden geçirme yazısında, somatizasyonun depresyon ve anksiyete bozukluklarının klinik görünümünü, tanı ve tedavi sürecini, prognozunu nasıl etkileyebileceği derlenen bilgiler ışığında değerlendirilmektedir. Anahtar kelimeler: Somatizasyon, depresyon, anksiyete bozuklukları, disfori, bedensel ABSTRACT Somatization in depression and anxiety disorders Somatization may be described as the tendency to express psychological dysphoria through bodily symptoms. Patients complain of physical signs which they attribute to a medical disease and seek medical help for, but the symptoms do not fullfill diagnostic criteria of an organic disorder. Although somatization is known to be associated with many psychiatric disorders, it mostly accompanies depression and anxiety disorders. Somatic symptoms are thought to be a manifestation of somatized dysphoria in depression and/or anxiety. Somatization, stil accepted to be an unsolved problem in the borderland of medicine and psychiatry, leads to an increase in psychological distress and disability of patients and worsens the prognosis of psychiatric disorders. On the other hand, somatization may mask real psychiatric symptomatology leading to a delay in true diagnosis and effective treatment. This review aims to evaluate the effects of somatization on the clinical picture, diagnosis, treatment and prognosis of depression and anxiety disorders.
$365 to mirtazapine does not result in a clinically relevant pharmacokinetic drug-drug interactio... more $365 to mirtazapine does not result in a clinically relevant pharmacokinetic drug-drug interaction. The combination was well tolerated and no major clinically relevant adverse events were observed Conclusion: Despite a limited number of patients the present data suggest that a combination of risperidone and mirtazapine does not necessitate a change of dose of either drug and is well tolerated •P300 amplitude is associated with genetic variations in the DRD3 dopamine receptor gene
Şizofreni Hastalarında Somatizasyonun Psikodinamik Anlamının Değerlendirilmesi Emine Müjgan ÖZEN,... more Şizofreni Hastalarında Somatizasyonun Psikodinamik Anlamının Değerlendirilmesi Emine Müjgan ÖZEN, Doğan YEŞİLBURSA, Ali BELENE, Ayşe SOLMAZ TÜRKCAN, Erdal ... Bu durum, bedenle ilgili ikili bir kavram oluşmasına yol açar; bedenin geçmişte kalan varlığı ve şu anki ...
Two four-marker haplotypes on 7q36.1 region indicate that the potassium channel gene HERG1 (KCNH2... more Two four-marker haplotypes on 7q36.1 region indicate that the potassium channel gene HERG1 (KCNH2, Kv11.1) is related to schizophrenia: a case control study
Two four-marker haplotypes on 7q36.1 region indicate that the potassium channel gene HERG1 (KCNH2... more Two four-marker haplotypes on 7q36.1 region indicate that the potassium channel gene HERG1 (KCNH2, Kv11.1) is related to schizophrenia: a case control study
Background: The pathobiology of schizophrenia is still unclear. Its current treatment mainly depe... more Background: The pathobiology of schizophrenia is still unclear. Its current treatment mainly depends on antipsychotic drugs. A leading adverse effect of these medications is the acquired long QT syndrome, which results from the blockade of cardiac HERG1 channels (human ether-a-go-go-related gene potassium channels 1) by antipsychotic agents. The HERG1 channel is encoded by HERG1 (KCNH2, Kv11.1) gene and is most highly expressed in heart and brain. Genetic variations in HERG1 predispose to acquired long QT syndrome. We hypothesized that the blockade of HERG1 channels by antipsychotics might also be significant for their therapeutic mode of action, indicating a novel mechanism in the pathogenesis of schizophrenia. Methods: We genotyped four single nucleotide polymorphisms (SNPs) in 7q36.1 region (two SNPs, rs1805123 and rs3800779, located on HERG1, and two SNPs, rs885684 and rs956642, at the 3'-downstream intergenic region) and then performed single SNP and haplotype association a...
Fetishism is defined as the recurrent and intense use of nonliving objects for sexual arousal and... more Fetishism is defined as the recurrent and intense use of nonliving objects for sexual arousal and gratification. Kleptomania is defined as a recurrent failure to resist impulses to steal objects not needed for personal use or their monetary value. Both fetishism and kleptomania cases are generally sent mandatory to psychiatric clinics by courts. In this paper, a 32-year old male patient, followed-up with a diagnosis of fetishism and kleptomania, and referred for psychiatric evaluation as a result of multiple stealing of the “fetish”, with multiple jail experience and some social losses is reported, and fetishism and kleptomania are discussed with regard to the biological and dynamic approaches and forensic psychiatry. (Archives of Neuropsychiatry 2009; 46: 125-8) Key words: Fetishism, paraphilia, kleptomania, forensic psychiatry
Somatization which is the somatic way of expressing emotional distress and unconscious conflicts ... more Somatization which is the somatic way of expressing emotional distress and unconscious conflicts instead of words, frequently accompanies schizophrenia as well as many other psychiatric disorders. Schizophrenia patients have a specific interest in bodily sensations. Libidinal energy which is withdrawn from objects is transferred to the body (soma) and the body remains to be the only real object to communicate with. It’s known that schizophrenia may start with somatic and hypochondriac symptoms, and that hypochondriac symptoms may also emerge during the recovery periods in schizophrenia. On the other hand our clinical observations indicate that schizophrenia patients present with somatic complaints in any phase of the disorder. The association of schizophrenia and somatization has not been studied much. However, schizophrenia patients expressing somatic complaints are common in clinical practice. This review aims to evaluate the meaning of somatization in schizophrenia, to assess the...
Introduction Schizophrenia (SCH) is one of the major and potentially severe mental illness that i... more Introduction Schizophrenia (SCH) is one of the major and potentially severe mental illness that is characterized by both genetic and clinical heterogeneity. Thyroid hormone plays an important role in the development of the brain and nervous system both in the basic process of neurogenesis and of terminal brain differentiation. Type II deiodinase (DIO2) enzyme which has a critical role on thyroid hormone metabolism to convert pro-hormone thyroxine (T4) to the active hormone triiodothyronine (T3). Recently, DIO2 gene variations have been identified in association with mental disorders. Methods To investigate the potential genetic contribution of the DIO2 gene to SCH, we studied DIO2 Thr92Ala (rs225014) and ORFa-Gly3Asp (rs12885300) polymorphisms in a Turkish cohort of 290 unrelated SCH patients and 198 healthy controls. All subjects were genotyped by Taqman SNP genotyping assays. Results Single marker analysis showed a positive association of SCH and rs225014. Particularly, Thr92Ala genotype frequency was significantly higher in patients with SCH than controls (p=0.045) and in male patients with SCH, both allele and genotype frequencies were significantly higher compared to male controls (p=0.03). Allele and genotype frequencies of ORFa- Gly3Asp polymorphism were no different within the study group. Conclusion These data show a potential role of DIO2 as a candidate gene for susceptibility to SCH and provide a strong evidence for a role of the DIO2 Thr92Ala allele and genotype in the etiopathogenesis of SCH with sexual difference.
Antipsychotic medications can induce metabolic abnormalities (weight gain) in schizophrenia (SCH)... more Antipsychotic medications can induce metabolic abnormalities (weight gain) in schizophrenia (SCH). Leptin receptor (LEPR), leptin (LEP) and peroxysome proliferator-activated receptor g2 (PPARg2) are the potential genetic determinants which might be liable of the metabolic dysregulation. The aim of this study was to evaluate the effect of LEP c.-2548G>A, LEPR p.Q223R polymorphisms and the impact of mRNA levels of LEP, LEPR, and PPARg2 along with the serum leptin levels on metabolic adversities in SCH patients (n=132) and controls (n=114). Methods: Metabolic profiles, LEP, LEPR gene polymorphisms and the gene expressions of LEP, LEPR and PPARg2 were studied in SCH patients and controls. Results: BMI, cholesterol and fasting glucose levels were higher in SCH patients compared to controls. LEP c.-2548 (GA+AA) genotypes were two fold lower in SCH patients versus controls (p< 0.05), and no significant difference was observed in LEPR p.Q223R genotypes. Interestingly, leptin serum levels were lower in SCH patients compared to controls (p< 0.05). Leptin, leptin receptor and PPARg2 gene expressions were found to be decreased in SCH patients compared to controls (p< 0.001, p< 0.001 and p 0.05, respectively). Conclusion: Leptin receptor, leptin and PPARg2 genes could be potential risk factors in developing metabolic adversities in SCH.
Schizophrenia is a chronic illness with great economic burden. Paliperidone ER is a new atypical ... more Schizophrenia is a chronic illness with great economic burden. Paliperidone ER is a new atypical antipsychotic drug in Turkey. The aim of the study is to estimate the costeffectiveness of paliperidone ER compared to other oral atypicals (risperidone, olanzapine, quetiapine, ziprasidone and aripiprazole) in acute phase of schizophrenia. METHODS: Model: An existing decision analytic model is adapted (based on literature and expert panels). The time horizon is six weeks. The study is performed from the health care payer perspective. Patient group: Patients diagnosed with schizophrenia that have suffered an acute exacerbation. Data sources: The clinical data are acquired from the literature. Resource use data are derived via expert panel. Prices of medications, institutional discount rates and other costs related to the treatment are obtained from
Schizophrenia is a chronic illness with great economic burden. Paliperidone ER is a new atypical ... more Schizophrenia is a chronic illness with great economic burden. Paliperidone ER is a new atypical antipsychotic drug in Turkey. The aim of the study is to estimate the costeffectiveness of paliperidone ER compared to other oral atypicals (risperidone, olanzapine, quetiapine, ziprasidone and aripiprazole) in acute phase of schizophrenia. METHODS: Model: An existing decision analytic model is adapted (based on literature and expert panels). The time horizon is six weeks. The study is performed from the health care payer perspective. Patient group: Patients diagnosed with schizophrenia that have suffered an acute exacerbation. Data sources: The clinical data are acquired from the literature. Resource use data are derived via expert panel. Prices of medications, institutional discount rates and other costs related to the treatment are obtained from
Fetishism is defined as the recurrent and intense use of nonliving objects for sexual arousal and... more Fetishism is defined as the recurrent and intense use of nonliving objects for sexual arousal and gratification. Kleptomania is defined as a recurrent failure to resist impulses to steal objects not needed for personal use or their monetary value. Both fetishism and kleptomania cases are generally sent mandatory to psychiatric clinics by courts. In this paper, a 32-year old male patient, followed-up with a diagnosis of fetishism and kleptomania, and referred for psychiatric evaluation as a result of multiple stealing of the "fetish", with multiple jail experience and some social losses is reported, and fetishism and kleptomania are discussed with regard to the biological and dynamic approaches and forensic psychiatry.
Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 2010
Genel olarak emosyonel disforiyi bedensel belirtilerle ifade etme eğilimi olarak tanımlanan somat... more Genel olarak emosyonel disforiyi bedensel belirtilerle ifade etme eğilimi olarak tanımlanan somatizasyonda, "bedensel bir hastalıkla açıklanamayan fiziksel yakınmalar" mevcuttur ve kişi bu yakınmalarını bedensel bir hastalığa atfederek tıbbi yardım arayışına girer. Somatizasyon (bedenselleştirme) davranışı çeşitli psikiyatrik bozukluklarla ilişkilendirilmekle birlikte, en sık olarak depresyon ve anksiyete bozukluklarına eşlik ettiği bilinmektedir. Anksiyete bozuklukları ve majör depresyon vakalarında, somatik belirtilerin somatize edilmiş disforiyi yansıttığı düşünülmektedir. Psikiyatri ve genel tıp sınırında hala çözülememiş bir sorunun temsilcisi olan somatizasyon, hastaların yaşadıkları sıkıntı ve huzursuzluğu arttırmakta, hastalıkların gidişatını kötüleştirmekte ve yeti yitimini arttırmaktadır. Diğer yandan somatizasyon, depresyon ve anksiyete belirtilerini maskeleyerek doğru tanı koymayı güçleştirebilmekte ve tedavinin gecikmesine neden olabilmektedir. Bu sistematik olmayan gözden geçirme yazısında, somatizasyonun depresyon ve anksiyete bozukluklarının klinik görünümünü, tanı ve tedavi sürecini, prognozunu nasıl etkileyebileceği derlenen bilgiler ışığında değerlendirilmektedir. Anahtar kelimeler: Somatizasyon, depresyon, anksiyete bozuklukları, disfori, bedensel ABSTRACT Somatization in depression and anxiety disorders Somatization may be described as the tendency to express psychological dysphoria through bodily symptoms. Patients complain of physical signs which they attribute to a medical disease and seek medical help for, but the symptoms do not fullfill diagnostic criteria of an organic disorder. Although somatization is known to be associated with many psychiatric disorders, it mostly accompanies depression and anxiety disorders. Somatic symptoms are thought to be a manifestation of somatized dysphoria in depression and/or anxiety. Somatization, stil accepted to be an unsolved problem in the borderland of medicine and psychiatry, leads to an increase in psychological distress and disability of patients and worsens the prognosis of psychiatric disorders. On the other hand, somatization may mask real psychiatric symptomatology leading to a delay in true diagnosis and effective treatment. This review aims to evaluate the effects of somatization on the clinical picture, diagnosis, treatment and prognosis of depression and anxiety disorders.
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