Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item The Effect of Infliximab on Depressive Symptoms in Patients with Ankylosing Spondylitis(2015) Ersozlu Bozkirli, E. D.; Keskek, S. O.; Bozkirli, E.; Yucel, A. E.; 0000-0002-1644-6790; 25702318; I-6542-2012; E-9887-2014; 0000-0002-4860-9072Objectives: Ankylosing spondylitis is a chronic inflammatory disease which physically, psychologically, and socially affects the patient's life. Previous studies have reported a correlation between ankylosing spondylitis and depression. In this study we investigated the effect of infliximab on depression in ankylosing spondylitis patients. Methods: A total of 29 patients with ankylosing spondylitis were enrolled in this prospective study Infliximab was administered intravenously at a dose of 5 mg//kg at baseline, weeks 2 and 6. The measurements of morning stiffness, modified Schober's test, chest expansion, erythrocyte sedimentation rate, C-reactive protein, Bath ankylosing spondylitis disease activity index, Bath ankylosing spondylitis functional index and Beck depression inventory scores were compared between baseline and 12th week. Results: The modified Schobers' quotes test and chest expansion increased, the morning stiffness duration, erythrocyte sedimentation rate and C-reactive protein levels decreased after infliximab treatment (p<0.001, respectively). There was statistically significant decrease in Bath ankylosing spondylitis disease activity index, Bath ankylosing spondylitis functional index and Beck depression invantory scores of patients after 12 weeks (p<0.001, respectively). Conclusion: Infliximab can improve depression and its symptoms in patients with ankylosing spondylitis.Item Self-Efficacy, Depression and Self-Care Activities of People with Type 2 Diabetes in Turkey(2017) Kav, Sultan; Yilmaz, Arzu Akman; Bulut, Yasemin; Dogan, Nevin; 29218959Background: Self-efficacy related to self-care behaviors in people with type 2 diabetes has been well reported. However no work has been reported in Turkey that uses reliable instruments to examine the relationships among self-care activities, depression and self-efficacy. Aim: This study aims to investigate self-care activities, depression and self-efficacy among people with type 2 diabetes in Turkey. Methods: The sample included 200 patients with type 2 diabetes from an endocrinology out-patient clinic at a university hospital. Self-care activities, self-efficacy, and symptoms of depression were measured using established instruments: The Summary for Diabetes Self Care Activities, the Self-Efficacy Scale, and the Beck Depression Inventory. Descriptive and correlational statistics were used in data analysis. Findings: One in three (37.5%) of participants had depression symptoms. Beck Depression Inventory scores were higher in women and in those with a lower education level, had diabetic complications and difficulty in meeting health care costs. The mean self-efficacy score was 66.5 14.0; those who lived alone, were unemployed and knew their HbA1c level had significantly higher scores (p <.05). Demographic and diabetes characteristics including age, education, social support, diabetes complications, HbA1c level, and having diabetes education were found to be significantly associated with all self-care activities except smoking.Conclusion: The association between self-efficacy and self-care activities was positive. Interventions to improve patients' self-efficacy and self-care are needed in order to maximize diabetes self-management.(C) 2015 Australian College of Nursing Ltd. Published by Elsevier Ltd.Item Factors Affecting Risk of Anxiety and Depression Among Diabetic and Hypertensive Patients Who Refer to Family Health Centers(2018) Emre, Nilufer; Topal, Kenan; Edirne, Tamer; Gereklioglu, CigdemThis cross-sectional study was carried out to investigate the factors which influence risk of anxiety and depression among diabetic and hypertensive patients who refer to family health centers. The Hospital Anxiety and Depression Scale (HADS) was applied for assessment of emotional status of the patients and the Hypertension Compliance Assessment Scale (HCAS) was applied for assessment of adherence to anti-hypertensive therapy. Of a total of 380 patients, 170 had hypertension (HT), 83 had type 2 diabetes mellitus (T2DM), and 127 had both HT and T2DM. According to HADS, 18.7% of the patients had risk of anxiety, 24.7% had risk of depression, and 12.6% had both risk of anxiety and depression. Mean HAD-Anxiety (HADS-A) score and HADS-Depression (HADS-D) score were significantly lower in the patients who had an adequate compliance to medication therapy (5.1 +/- 4.1 and 3.8 +/- 3.4, respectively) compared to the patients who had a low compliance to therapy (7.6 +/- 4.3 and 5.8 +/- 4.0, respectively) according to the Hypertension Compliance Assessment Scale ((2)=15.26, p<0.01 and (2)=13.80, p<0.01). Mean HADS-D score was found significantly lower among the diabetic patients with good glycemic control (3.7 +/- 2.9) compared to the patients with poor glycemic control (4.5 +/- 3.7) ((2)=25.00, p<0.05). Anxiety and depression are among the most frequent disorders as hypertension and diabetes in primary care setting. We revealed that risk of anxiety and/or depression was greater among hypertensive and diabetic patients, consistently with the previous studies. Our study also revealed that this condition negatively affected treatment compliance in hypertensive patients and glycemic control in diabetic patients.Item Anxiety, Depression, and Anger in Functional Gastrointestinal Disorders: A Cross-Sectional Observational Study(2018) Cakmak, Berna Bulut; Ozkula, Guler; Isikli, Sedat; Goncuoglu, Ibrahim Ozkan; Ocal, Serkan; Altinoz, Ali Ercan; Takintuna, Nilgun; 0000-0003-3719-9482; 0000-0003-2233-2105; 30103181; E-7929-2013; ABH-4817-2020; J-4811-2014Previous studies have identified a link between anger and somatization. However, little is known about the associations between anger and the development and progression of Functional Gastrointestinal Disorders (FGID). The study aim was to determine the associations between FGID and anger, anxiety, and depression. Participants in this cross-sectional observational study were 109 consecutive patients aged 18-64 years with FGID at Gastroenterology Clinic of Baskent University Hospital. A control group comprised of 96 individuals with no chronic gastrointestinal disorders recruited via snowball sampling. Sociodemographic and clinical information were obtained and participants completed the Hospital Anxiety and Depression Scale and the State-Trait Anger Expression Inventory-2. FGID participants scored higher than controls on depression, anxiety, state anger, and anger expression-in. When the FGID group was divided into upper and lower gastrointestinal symptom groups, the lower symptom group showed higher anger expression-out scores than the upper symptom group. Anger may contribute to the etiology and development of FGID. This is the first study to demonstrate a significant psychological difference between individuals with lower and upper FGID. Interdisciplinary collaboration with gastroenterologists and psychiatrists could strengthen FGID evaluation and may improve treatment compliance.Item Coexistence of restless legs syndrome and multiple sclerosis aggravates anxiety and depression(2022) Sevim, Serhan; Demirkiran, Meltem; Terzi, Murat; Yuceyar, Nur; Tasdelen, Bahar; Idiman, Egemen; Kurtuncu, Murat; Boz, Cavit; Tuncel, Deniz; Karabudak, Rana; Siva, Aksel; Ozcan, Abdulcemal; Neyal, Munife; Goksel Karakurum, Basak; Gazaloglu, Gulcan Baran; Balal, Mehmet; Sen, Sedat; Baklan, Meltem Alkaya; Gunduz, Tuncay; Tuncer, Asli; Uygunoglu, Ugur; 35195221Background: Among the comorbidities that accompany multiple sclerosis (MS), restless legs syndrome (RLS) is one of the most common. Anxiety and depression are common psychological comorbidities that impact the quality of life of patients with MS (PwMS), as well as patients with RLS. Objective: To investigate the psychiatric burden of MS and RLS coexistence, we conducted a nationwide, multicenter and cross-sectional survey. Methods: Participants were assessed by using demographic and clinical parameters along with the Hamilton Anxiety and Hamilton Depression Scales (HAM-A and HAM-D). Results: Out of the 1,068 participants, 173 (16.2%) were found to have RLS [RLS(+)] and 895 (83.8%) did not [RLS(-)]. The mean scores for HAM-A and HAM-D were significantly higher among RLS(+) subjects than among RLS(-) subjects (p<0.001 for all variables). Conclusions: According to our data, the presence of RLS in PwMS may increase the occurrence of both anxiety and depression symptoms. Awareness and treatment of RLS in PwMS could possibly reduce the symptoms of psychiatric comorbidities originating from RLS.Item Association between polarity of first episode and solar insolation in bipolar I disorder(2022) Bicakci, Sule; 0000-0003-4787-9860; 35932492; AAJ-8555-2021Objective: Circadian rhythm disruption is commonly observed in bipolar disorder (BD). Daylight is the most powerful signal to entrain the human circadian clock system. This exploratory study investigated if solar inso-lation at the onset location was associated with the polarity of the first episode of BD I. Solar insolation is the amount of electromagnetic energy from the Sun striking a surface area of the Earth. Methods: Data from 7488 patients with BD I were collected at 75 sites in 42 countries. The first episode occurred at 591 onset locations in 67 countries at a wide range of latitudes in both hemispheres. Solar insolation values were obtained for every onset location, and the ratio of the minimum mean monthly insolation to the maximum mean monthly insolation was calculated. This ratio is largest near the equator (with little change in solar insolation over the year), and smallest near the poles (where winter insolation is very small compared to summer insolation). This ratio also applies to tropical locations which may have a cloudy wet and clear dry season, rather than winter and summer. Results: The larger the change in solar insolation throughout the year (smaller the ratio between the minimum monthly and maximum monthly values), the greater the likelihood the first episode polarity was depression. Other associated variables were being female and increasing percentage of gross domestic product spent on country health expenditures. (All coefficients: P <= 0.001). Conclusion: Increased awareness and research into circadian dysfunction throughout the course of BD is warranted.Item The relationship between pain and clinical parameters, depression, anxiety and sleep quality in patients with spinal injury(2022) Balikci, Sibel; Bardak, Ayse NurObjective: To examine the frequency of pain in individuals with spinal cord injury, and to assess the relationship of pain with functional status, sleep quality, anxiety and depression levels. Method: The prospective, cross-sectional study was conducted from March to June 2018 at Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Istanbul, Turkey, and comprised adult patients of wither gender with spinal cord injury who were in the rehabilitation phase both on outpatient and inpatient basis. Data was collected using a questionnaire exploring demographic and clinical features. The presence of pain was assessed using the Leeds Assessment of Neuropathic Symptoms and Signs scale and, in case pain was found present, it was categorised as neuropathic, nociceptive and mixed type pain types. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index, while the Hospital Anxiety and Depression scale was used to evaluate anxiety and depression levels. Data was analysed using SPSS 20.Results: Of the 150 patients, 104(69.3%) were males and 46(30.7%) were females. The median age of the sample was 46 (IQR:20.52) years. Neuropathic pain was observed in 61(40.7%) patients, nociceptive in 32(21.3%) and mixed type in 12(8%). Depression was found in 71(47.3%) patients, poor sleep quality in 41(27.3%) and anxiety in 35(23.3%). Sleep, anxiety and depression scores were higher in the presence of neuropathic and nociceptive pain (p<0.05). Conclusion: Pain is a common complication in patients with spinal cord injury. In the presence of pain, sleep quality is worse, and anxiety and depression levels are high.Item Peer Bullying, Anxiety, and Depression Levels Among Turkish Children with Childhood Onset Fluency Disorder (COFD): A single-Center, Case-Control Study(2022) Kilicaslan, Fethiye; Cicek, Ekrem; Gungoren, Sumeyra; Kutuk, Meryem Ozlem; Tufan, Ali EvrenObjective: Childhood Onset Fluency Disorder (COFD) is associated with elevated levels of emotional/ behavioral problems and peer bullying. Studies on Turkish children with COFD are limited. We aimed to evaluate rates of peer bullying and its relationships with stuttering severity and symptoms of depression and anxiety among Turkish children with COFD.Methods: Forty 8-12 years old children with COFD without comorbid neurological/ medical disorders and 36 age - and gender-matched controls were evaluated with self-report scales for depression, trait/ state anxiety and peer bullying. Stuttering severity was evaluated with Stuttering Severity Instrument-4. Multivariate and bivariate analyses were used in comparisons. P was set at 0.05.Results: COFD group had significantly elevated depression and state anxiety scores while trait anxiety was elevated but at trend levels. 52.5 % of children with COFD was bullied while this rate was 27.8 % for controls (Odds Ratio= 2.9). Bullying was not related with gender, self-reported symptoms and stuttering severity.Conclusion: Standardized trainings/practices should be introduced among Turkish speech and language therapists to screen and address peer bullying, depression, and anxiety among children with COFD in collaboration with child and adolescent psychiatrists.Item Psychological domain of quality of life, depression and anxiety levels inin vitrofertilization/intracytoplasmic sperm injection cycles of women with endometriosis: a prospective stud(2020) Ceran, M. U.; Yilmaz, N.; Ugurlu, E. N.; Erkal, N.; Ozgu-Erdinc, A. S.; Tasci, Y.; Gulerman, H. C.; Engin-Ustun, Y.; 0000-0003-1923-2373; 32635772Objective To evaluate the psychological domain of quality of life (PDQoL), anxiety and depression levels of infertile women with endometriosis versus non endometriosis who applied for Assisted Reproductive Technologies (ART). Method This prospective case-control study compromised a total of 105 women who applied for IVF/ICSI program. Ninety-three women were divided into two groups as endometriosis (n = 37) and non-endometriosis (n = 56) after 12 patients who refused to participate in the study were excluded. The WHOQOL-BREF questionnaire, Beck Depression and Anxiety Inventory scales were used to determine the psychological stress levels. Results A significant difference was found between the endometriosis and non-endometriosis groups regarding depression scores, while no significant difference was reported with respect to PDQoL and anxiety (p < 0.01,p = 0.897 andp = 0.058, respectively). A weak but significant correlation was observed between depression and endometriosis (CC: 0.435,p < 0.01). Though anxiety scores were found to be higher in endometriosis group this can not reach statistical significance (p = 0.058). Impact of PDQoL, depression and anxiety scores on pregnancy outcomes were found to be insignificant. Conclusion Women with endometriosis seem to be more susceptible to depression and anxiety than women without endometriosis. Although infertility treatment outcomes are not found to be significantly affected, the impact of depression and anxiety over ART treatment success merit further research.Item Relationship Among Coping Strategies, Quality of Life, and Anxiety and Depressive Disorders in Hemodialysis Patients(2019) Ulusoy, Selen Isik; Kal, Oznur; 0000-0003-2550-8989; 31233289Patients with hemodialysis face many physical and emotional stressors; yet little is known regarding coping strategies and their effects on patients' quality of life (QOL) and anxiety and depressive disorders. A total of 117 patients were enrolled in this cross-sectional study between October 2016 and April 2017. This study assessed QOL (Medical outcome short form 36-MOS 36), coping (Assessment Scale for Coping Attitudes-COPE) and psychiatric comorbidities in hemodialysis patients. Beck Depression Scale and Beck Anxiety Scale were also applied. Differences between groups were evaluated using Student's t-tests and anova. Correlations among parameters were performed. Patients with any depressive disorder (22.2%, n = 26) and patients with any anxiety disorder (19.6%, n = 23) reported more impaired QOL. The most frequently used coping strategy in all patients was religious coping. Use of instrumental social support, humor, and positive reinterpretation scores were lower in patients with any depressive disorder (P = 0.009, P = 0.034, P = 0.047).The total score of emotion-focused coping strategies was lower with patients with any depressive disorder (P = 0.021) and emotion-focused coping strategies were positively correlated with QOL scores. Younger age and longer duration of hemodialysis have significant negative correlation with emotion-focused coping strategies' total score (P = 0.01, P = 0.02). Patients with hemodialysis use variety of coping strategies. The use of emotion-focused coping was associated with better QOL and reducing the risk of depressive disorder. Interventions to facilitate the use of adaptive coping strategies may improve patients' QOL and mood.