To determine the effects of trazodone, mirtazapine and hydroxyzine on sleep profiles of dysthymic disorder (DD) women with selective serotonin reuptake inhibitor (SSRI) treatment and compare their polysomnographic measurements with controls. Among 36 patients trazodone receiving (n = 9), mirtazapine receiving (n = 8), hydroxyzine receiving (n = 8) and only SSRI receiving (n = 11) patients were compared to each other and to controls in terms of polysomnographic (PSG) findings. Rapid eye movements (REM) ratio and sleep onset time (SO) were higher; slow wave sleep (non-REM3) ratio and total sleep duration (TSD)) and sleep efficiency (SE) were lower in patients when compared with controls. Increased REM ratio and SO; decreased non-REM3 ratio and TSD and SE were found in both only SSRI receiving patients and hydroxyzine receiving patients when compared with controls. Only SSRI receiving patients also showed increased non-REM1 ratio. Trazodone or mirtazapine receiving patients showed no difference than controls. When PSG assessment is considered, it can be suggested that both trazodone and mirtazapine improve sleep problems in DD patients with SSRI treatment, but hydroxyzine does not.
This study aims to identify the help seeking behaviours of patients from two geographically distinct provinces of Turkey. A questionnaire about sociodemographic characteristics and help seeking ways was applied to 49 schizophrenia patients from Van, 99 from Ankara. The ratio of patients seeking psychiatric help at the beginning of their illness was 76% in Ankara, the capital city, in contrast to 54% in Van (p = 0.01). Twenty-two percent of patients from Ankara and 69% from Van reported that non-psychiatric help seeking was the choice of their families (p < 0.001). Thirty-five percent of all patients sought religious support when their symptoms started. Patients with lower education levels sought more religious help (p = 0.002). Help seeking behaviours show regional variations. Religious help seeking behaviour is a major way of dealing with the illness. Psychoeducation is a crucial need both for patients and families.
Domestic violence (DV) against women is a serious problem with its negative effects on all family members and the society. Women exposed to DV not only have physical but also psychological damage. This study investigates prevalence of DV and its relations with some descriptive and clinical features in a psychiatric outpatient population in Turkey. A total of 277 female outpatients were included in the study. After a semistructured clinical interview, they were assessed by sociodemographic data form, DV questionnaire, Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), Dissociative Experiences Scale (DES), and Somatoform Dissociation Questionnaire (SDQ). Prevalence of exposure to DV by intimate partner is found to be 58.8% ( n = 163). The current study provided strong evidence that occupation status of the woman, education level of the partner, and family type are predictors of DV. Another predictor of DV exists where the child is battered by either parent. Prevalence of depression, conversion disorder, and other somatoform disorders are higher in women exposed to DV. These women also have higher scores from HDRS, HARS, DES, and SDQ compared with female patients who have not experienced DV ( p < .001). Number of women scoring above cutoff levels for DES and SDQ were significantly higher in women exposed to DV ( p < .001).
Help seeking behavior and related factors in schizophrenia patients: a comparative study of two populations from eastern and western TurkeyObjective: In this study, it is aimed to investigate and compare the properties of help-seeking behaviour of schizophrenia patients from two districts situated in eastern and western Turkey.Method: Thirty one schizophrenia patients admitted to Tatvan State Hospital in 2006 and 41 schizophrenia patients admitted to Menemen State Hospital in 2007 were recruited in the study. All the patients were in remission. A semi-structured, short questionnaire type interview was carried out with the patients inquiring about their socio-demographic properties and the ways they explain and seek help for their illness.Results: The populations from Tatvan and Menemen significantly differed in terms of educational and income levels. Mean education duration of patients was 4.3±4.2 years for Tatvan and 6.8±3.5 years for Menemen (p=0.008). Fourty five percent of patients from Tatvan were of low income level and 54% of patients from Menemen were of middle-income level (p=0.016). Seventy four percent of all patients seeked help from religious sources for their illness. The percentage of patients seeking for psychiatric help was 85 for Menemen and 32 for Tatvan (p<0.001). Patients with education level of secondary-school and higher seeked for psychiatric help more than the less educated patients (p=0.039). Seventy one percent of all patients were advised to consult a psychiatrist by their family members.Discussion: This study revealed that a substantial proportion of schizophrenia patients from the two different districts were in seek of help from religious sources. Seeking for psychiatric help increased with increasing education level which indicates the importance of implementation and development of psychoeducational programs for both patients and their families. Bulgular: Tatvan ve Menemen'deki popülasyonlar eğitim ve gelir seviyeleri açısından birbirinden farklıydı. Tatvan'daki hastaların eğitim yılı ortalaması 4.3±4.2 iken, Menemen'dekilerin 6.8±3.5 yıl idi (p=0.008). Gelir düzeyi açısından Tatvan'daki hastaların %45'i düşük gelirliyken, Menemen'deki hastaların %54'ü orta gelirliydi (p=0.016). Tüm hastaların %74'ü hastalıkları sürecinde dinsel çare arayışı içinde bulunmuşlardı. Her iki gruptaki hastaların hastalıkları için ne tür çare arayışları içinde oldukları sorgulandığında Menemen'deki hastaların %85'i psikiyatriste gitmeyi tercih ederken, Tatvan'da bu oran %32 idi (p<0.001). Eğitim düzeyi ortaokul ve üstü olanlar, ilkokul ve altı olanlara göre hastalıkları için daha çok psikiyatriste gitmeyi tercih etmekteydi (p=0.039).Hastaların %71'i ailelerinin tavsiyesiyle psikiyatriye başvurmuştu.Tartışma: Her iki bölgede şizofreni hastalarının önemli bir oranının şizofreni ile baş etmede yüksek oranda dinsel çare arayışı içinde oldukları tespit edilmiştir. Eğitim düzeyi yükseldikçe psikiyatriye başvuru oranlarının artması, ruhsal eğitim programlarının geliştirilmesinin ve uygulanmasının önem...
Modafinil is used in the treatment of excessive day time sleepiness associated with several clinical conditions. It can also be used for affective stimulation for working late and/or concentrating for a long time. The reported cases of psychosis associated with modafinil use in the literature, have medical or psychiatric diorders. There is only one reported case without medical or psychiatric disorder but developed modafinil related psychosis, which is a case under simulated shift work in laboratory conditions. The cases in the literature are reported to develop mania or psychosis with 200-400 mg/day or higher doses. The case reported in this manuscript develop psychosis with 100 mg/day dosage. This case has no previous psychiatric and medical disorder history and not being on a shift work. The aim of modafinil use in this case was reported as increasing the concentration and performance while studying. Modafinil using patients must be psychiatrically monitored for its potential psychotic effect even in previously healthy individuals and low doses.
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