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Öğe Add-on therapy with pramipexole in treatment resistant dysthymic disorder: A case report(KURE ILETISIM GRUBU A S, 2009) Zeytinci, Esra; Uguz, Faruk; Sahingoz, Mine; Sari, Serap; Kayhan, FatihAdd-on therapy with pramipexole in treatment resistant dysthymic disorder: A case report Despite a wide range of alternative antidepressant drugs, a considerable rate of patients with dysthymic disorder do not response to these treatments. Usually combined pharmacological drugs and augmentation therapies are used to manage this chronic psychiatric disorder. Pramipexole, a new dopamine agonist, is approved for Parkinson's disease and restless leg syndrome but accumulating evidence suggests the usage of the drug as an antidepressant. We present a young man with a history of dysthymic disorder for 15 years who improved after adding low dose pramipexole to the prior treatment.Öğe A Case of Myoclonic Symptoms After Streptococcal Infection: Possible PANDAS Variant(GALENOS YAYINCILIK, 2011) Ceylan, Mehmet Fatih; Selek, Salih; Zeytinci, Esra; Savas, HalukPediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is defined as exacerbation of obsessive-compulsive disorder and/or tic disorder after streptococcal infections. New accumulating evidence suggests that PANDAS have some variants such as infantile-onset type, adult-onset type, myoclonic type, and dystonic type. In this report, we present the case of a fifteen-year-old adolescent who had myoclonic symptoms in the shoulders and was first treated for epilepsy and later, for conversion disorder until the diagnosis of PANDAS was established. (Archives of Neuropsychiatry 2011; 48: 85-7)Öğe The impact of obsessive-compulsive disorder in pregnancy on quality of life(TAYLOR & FRANCIS LTD, 2008) Gezginc, Kazim; Uguz, Faruk; Karatayli, Savas; Zeytinci, Esra; Askin, Ruestem; Gueler, Oezkan; Sahin, FigenAim. To examine the effects of obsessive-compulsive disorder (OCD) on quality of life in pregnant women. Material and method. Twenty-five pregnant women diagnosed as OCD in two university outpatient clinics were included for the study. Twenty-five pregnant women with no mental disorders and the same sociodemographic properties were taken as the control group. The diagnosis of OCD was confirmed with the DSM-IV Axis-I Disorders Structured Clinic Interview Diagnosis/Clinic Version (SCID-I/CV). In order to measure the severity of OCD Yale-Brown Obsession and Compulsion Scale was performed. Quality of life was evaluated by WHO (World Health Organisation) Life Quality Scale - Short Form (WHOQOL-Brief). Results. The whole subgroup of points of WHOQOL-Brief was significantly lower in OCD patients compared to control group (in all subgroups P < 0.01). There was a negative correlation between the Y-BOCS obsession and compulsion subpoints and total points with the physical health (P < 0.05), psychological health (P < 0.001) and social relationship (P < 0.01) of WHOQOL-Brief. No significant association was found with enviromental areas. Besides, there was a negative correlation between the duration of OCD and WHOQOL-Brief psychological health subarea (P < 0.05). Conclusion. OCD negatively effects the quality of life in pregnant women and is correlated with the severity of the disorder.Öğe Polikliniğe Başvuran Epilepsili Hastalarda Obsesif Kompulsif Bozukluk: Sıklık ve Klinik Özellikler(Kure İletişim Grubu A Ş, 2010) Çilli, Ali Savaş; Uğuz, Faruk; Zeytinci, Esra; Seren, Behiç; Genç, Emine; Genç, Bülent OğuzObjective: In the present study, we aimed to investigate the prevalence and symptomatology of and factors associated with obsessive-compulsive disorder in epilepsy patients. Methods: A total of 155 consecutive patients with epilepsy between ages 18 and 60, who presented to epilepsy outpatient clinic of a university hospital were included in this study. Patients with additional neurological disorders other than epilepsy; epilepsy secondary to head trauma, metabolic disorders, and intracranial problems; patients with severe medical diseases; mental retardation, and patients who received psychotropic medications during the last month were excluded from the study. Sociodemographic properties of patients, type of epilepsy, and antiepileptic medications were recorded. Types of epilepsy were recorded clinically as simple partial, complex partial, juvenile absence, juvenile myoclonic, generalized tonic-clonic, and others. Type of epilepsy according to EEG was recorded as temporal lobe epilepsy and non-temporal lobe epilepsy. SCID-I (Structured Clinical Investigation of Disease) for axis I was used to diagnose OCD for DSM-IV. Yale-Brown Obsession Compulsion Scale was used for the types of obsessions and compulsions among the OCD diagnosed patients. Results: Nine (5.8%) patients met the criteria for OCD. The most common obsessions were contamination (66.7%), aggression (44.4%), religious (22.2%) and symmetry/exactness (22.2%) whereas the most common compulsions were cleaning/washing (66.7%), checking (66.7%), repeating rituals (22.2%) and orderliness/sorting (22.2%), respectively. Patients with temporal lobe epilepsy had a higher frequency of OCD than patients with non-temporal lobe epilepsy. The correlation between levetiracetam use and OCD was found to be marginally significant. No correlation was detected between OCD and other anticonvulsants. The mostly used anticonvulsants were oxcarbazepine (35.5%), carbamazepine (31.6%) and valproic acid (34.2%). The most frequent clinically diagnosed epilepsy types were generalized tonic-clonic (34.2%) and complex partial epilepsy (27.1%). Twenty five patients had temporal lobe epilepsy (16.1%) and others had nontemporal epilepsy (83.9%). There were no difference between the groups regarding age, sex, duration of illness, education level, marital status, and anticonvulsant use. Prevalence of OCD was 10.5% (n=2) among the patients with juvenile myoclonic seizures, 9.5% (n=4) with complex-partial and 5.7% (n=3) with generalized tonic-clonic seizures. OCD was not diagnosed among the patients with other types of epilepsy. However, there was no significant relation between clinically diagnosed type of epilepsy and the prevalence of OCD. Prevalence of OCD was higher among the patients with temporal lobe epilepsy (16%) than nontemporal lob epilepsy patients (3.8%). Conclusion: The results suggest that the prevalence of OCD among a group of outpatients who are in treatment for epilepsy, especially temporal lobe focus, is relatively higher than the prevalence in the community. Although, the symptomatology of obsessions and compulsions seems to be similar between the epilepsy patients and general OCD patients, there is a need for controlled studies with larger sample sizes.Öğe Polikliniğe Başvuran Epilepsili Hastalarda Obsesif Kompulsif Bozukluk: Sıklık ve Klinik Özellikler(2010) Çilli, Ali Savaş; Uğuz, Faruk; Zeytinci, Esra; Seren, Behiç; Genç, Emine; Genç, Bülent OğuzAmaç: Bu çalışmada epilepsili hastalarda obsesif kompulsif bozukluğun (OKB) sıklığı, semptomatolojisi ve ilişkili etkenlerin araştırılması amaçlandı. Yöntem: Çalışmaya bir üniversite hastanesinin epilepsi polikliniğine başvuran 18-60 yaş arasında ardışık 155 hasta alındı. Epilepsi dışında halen ek nörolojik hastalığı olanlar; epilepsisi kafa travması, metabolik sorunlar ve intrakranial olaylar gibi ikincil nedenlere bağlı gelişmiş olanlar; halen şiddetli ek bir tıbbi hastalığı olanlar; zeka geriliği bulunanlar ve son 1 ay içinde psikotrop ilaç alanlar çalışmaya alınmadı. Hastaların sosyodemografik özellikleri, epilepsi türü ve aldığı antiepileptik ilaçlar kaydedildi. Epilepsi türleri klinik olarak basit parsiyel, kompleks parsiyel, jüvenil absans, jüvenil miyoklonik, jeneralize tonik-klonik ve diğerleri olarak kategorize edildi. EEG sonuçlarına göre ise epilepsi türleri temporal ve non-temporal olarak sınışandırıldı. OKB tanısı DSM-IV Eksen I Bozuklukları İçin Yapılandırılmış Klinik Görüşme / Klinik Versiyon (SCID-I / CV) ile kondu. OKB tanısı alanlarda obsesif kompulsif belirtilerin türleri ve şiddetini saptamak için Yale-Brown Obsesyon Kompulsiyon Ölçeği (YBOKÖ) kullanıldı. Bulgular: Dokuz (%5.8) hasta OKB tanısı için ölçütleri karşıladı. En sık obsesyonlar bulaşma (%66.7), saldırganlık (%44.4), dinsel (%22.2) ve simetri/keskinlik (%22.2), en sık kompulsiyonlar ise yıkama/temizleme (%66.7), kontrol etme (%66.7), yineleme (%22.2) ve düzenleme/sıralama (%22.2) idi. Temporal lob epilepsili hastalarda OKB sıklığı nontemporal lob epilepsili hastalardan daha fazlaydı. Levetirasetam kullanımı OKB ile sınırda anlamlı derecede ilişkili bulundu. Hastaların en sık kullanmakta oldukları antiepileptik ilaçlar okskarbazepin (%35.5), karbamazepin (%31.6) ve valproik asitti.(%30.3). Klinik olarak hastalardaki en sık epilepsi türleri jeneralize tonik-klonik (%34.2) ve kompleks parsiyeldi. (%27.1). Hastaların 25’i (%16.1) temporal lob epilepsi, geri kalanı (%83.9) nontemporal lob epilepsiye sahipti. OKB’si olan ve olmayan gruplar arasında yaş, cinsiyet, hastalık süresi, eğitim durumu, medeni durum ve kullanılan antiepileptikler yönünden anlamlı fark bulunmadı. OKB sıklığı jüvenil miyoklonik nöbetleri olanlarda %10.5 (s2), kompleks parsiyel nöbetleri olanlarda %9.5 (s4) ve jeneralize tonik-klonik nöbet geçirenlerde %5.7 (s3) olarak saptandı. Diğer epilepsi türlerine sahip hastalar arasında OKB bulunmadı. Bununla birlikte, klinik epilepsi türleri ile OKB sıklığı arasında anlamlı bir ilişki yoktu. Temporal lob epilepsili hastalarda OKB sıklığı (%16) temporal lob epilepsisi olmayanlardan (%3.8) yüksek bulundu. Sonuç: Bulgularımız, özellikle temporal lob kökenli olmak üzere, tedavi altındaki bir grup ayaktan epilepsi hastasında OKB’nin toplumdaki yaygınlığından nispeten sık olduğunu göstermektedir. Epilepsili hastalarda görülen obsesif kompulsif semptomların genel olarak epilepsisi olmayanlara benzer olduğu düşünülebilirse de, konu ile ilgili daha geniş örneklemli ve kontrollü çalışmalara ihtiyaç vardır.
