The purpose of the study was to examine psychopathological traits and psychiatric co-morbidities ... more The purpose of the study was to examine psychopathological traits and psychiatric co-morbidities in seekers of cosmetic rhinoplasty. Fifty persons seeking cosmetic rhinoplasty and 50 control subjects were admitted to the study. Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Symptom Checklist-90 [Revised] (SCL-90-R) were administered to people who requested cosmetic rhinoplasty and control subjects. All participants were also screened by the Structured Clinical Interview for DSM-IV-(SCIDI/CV, SCID-II). Thirteen cosmetic rhinoplasty seekers [CRS] (26%) and three control subjects (6%) had at least one psychiatric diagnosis. There was a significant difference between the two groups (p = 0.006). Beck depression inventory (p = 0.002) and BAI (p = 0.046) levels above the cut-off point were significantly higher in the CRS group than in the normal control. Somatoform disorders were statistically higher in the CRS than control group (p = 0.007). Nine CRS (18%) and two contr...
A possible relationship has been suggested between social anxiety and dissociation. Traumatic exp... more A possible relationship has been suggested between social anxiety and dissociation. Traumatic experiences, especially childhood abuse, play an important role in the aetiology of dissociation. This study assesses childhood trauma history, dissociative symptoms, and dissociative disorder comorbidity in patients with social anxiety disorder (SAD). The 94 psychotropic drug-naive patients participating in the study had to meet DSM-IV criteria for SAD. Participants were assessed using the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D), the Dissociation Questionnaire (DIS-Q), the Liebowitz Social Anxiety Scale (LSAS), and the Childhood Trauma Questionnaire (CTQ). Patients were divided into two groups using the DIS-Q, and the two groups were compared. The evaluation found evidence of at least one dissociative disorder in 31.91% of participating patients. The most prevalent disorders were dissociative disorder not otherwise specified (DDNOS), dissociative amnesia, and depersonalization disorders. Average scores on LSAS and fear and avoidance sub-scale averages were significantly higher among the high DIS-Q group (p < .05). In a logistic regression taking average LSAS scores as the dependent variable, the five independent variables DIS-Q, CTQ-53 total score, emotional abuse, sexual abuse, and emotional neglect were associated with average LSAS scores among patients with SAD (p < .05). It is concluded that, on detecting SAD symptoms during hospitalization, the clinician should not neglect underlying dissociative processes and traumatic experiences among these patients.
In this article, it is aimed to review the efficacies of mood stabilizers and atypical antipsycho... more In this article, it is aimed to review the efficacies of mood stabilizers and atypical antipsychotics, which are used commonly in psychopharmacological treatments of bipolar and borderline personality disorders. In this context, common phenomenology between borderline personality and bipolar disorders and differential features of clinical diagnosis will be reviewed in line with the literature. Both disorders can demonstrate common features in the diagnostic aspect, and can overlap phenomenologically. Concomitance rate of both disorders is quite high. In order to differentiate these two disorders from each other, quality of mood fluctuations, impulsivity types and linear progression of disorders should be carefully considered. There are various studies in mood stabilizer use, like lithium, carbamazepine, oxcarbazepine, sodium valproate and lamotrigine, in the treatment of borderline personality disorder. Moreover, there are also studies, which have revealed efficacies of risperidone,...
Abstract
The relationship between Panic Disorder (PD) and dissociation is well known. In this st... more Abstract
The relationship between Panic Disorder (PD) and dissociation is well known. In this study we aimed to investigate whether or not dissociative experiences affect the response to PD drug treatment. For this purpose, standart dose of venlafaxine was preferred for treatment. 63 patients with PD were included in the study. Venlafaxine treatment with increasing dose was administered to each patient during a 10-week period. The Panic Disorder Severity Scale (PDSS) and the Dissociation Questionnaire (DIS-Q) were applied to the patients at the
beginning of the study. Patients were divided into two groups based on DIS-Q scores. PDSS was applied again to both groups at the end of 10-week treatment. No difference between sociodemographic data and PDSS scores of two groups – patients with low DIS-Q scores (b2.5) and high DIS-Q scores (N2.5) – was found at the beginning. At the end of the study, a significant decrease in PDSS scores measured in both groups was detected. However, the decrease in PDSS score for the group with lower DIS-Q score was at a higher percentage (z = −3.822, p = 0.0001). These results depict that dissociative symptoms accompanying PD affect psychopharmacological treatment in a negative way. Reevaluation of dissociative symptoms at the beginning and end of treatment would help in planning personal therapy.
Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 2013
This article aims to review the effectiveness of mood stabilizers used in the psychopharmacologic... more This article aims to review the effectiveness of mood stabilizers used in the psychopharmacologic treatment of both bipolar disorder and borderline personality disorder. In this context, the overlapping phenomenology of borderline personality disorder and bipolar disorder and the differential diagnosis of clinical features will be also reviewed with the literature.
Both disorders can show common features in terms of diagnosis and overlap in phenomenological perspective. Coexistence of both disorders is quite frequent. The nature of mood shifts, types of impulsivity and the longitudinal course of the disorders should be considered to differenciate them. There are findings on the effectiveness of mood stabilizers such as lithium, carbamazepine, oxcarbazepine, sodium valproate or lamotrigine in the treatment of the borderline personality disorder. The differentiation of borderline personality disorder from bipolar disorder is not easy. A very careful evaluation is required. This differentiation may also be useful in terms of treatment. A greater number of research results are available on the effectiveness of valproate and lamotrigine in the treatment of borderline personality disorder. Findings related to other mood stabilizers are insufficient. In
the treatment of borderline personality disorder, there is not any drug approved by the official authorities. Psychotherapeutic approaches still retain their important place in the treatment. However, symptombased approach is proposed in the use of mood stabilizers.
This study assesses childhood trauma history, dissociative symptoms, and dissociative disorders c... more This study assesses childhood trauma history, dissociative symptoms, and dissociative disorders comorbidity in patients with Panic Disorder (PD). Ninety two psychotropic drug-naive patients with PD, recruited from outpatient clinics in the psychiatry department of a Turkish hospital were involved in the study. Participants were assessed with the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D), Dissociation Questionnaire (DIS-Q), Panic and Agoraphobia Scale (PAS), Panic Disorder Severity Scale (PDSS) and the Childhood Trauma Questionnaire (CTQ). Eighteen (19 %) of the patients with PD had comorbid dissociative disorder diagnosis upon screening with SCID-D. The most prevalent disorders were dissociative disorder not otherwise specified (DDNOS), dissociative amnesia, and depersonalization disorders. Patients with a high degree of dissociation symptoms and dissociative disorder comorbidity had more severe PD than those without (P<0.05). All of the childhood trauma subscales used were correlated with the severity of symptoms of dissociation and PD. Among all subscales, the strongest relationship was associated with childhood emotional abuse. Logistic regression analysis showed that emotional abuse and severity of PD were independently associated with dissociative disorder. In our study, a significant proportion of the patients with PD had concurrent diagnoses of dissociative disorder. We conclude that the predominance of PD symptoms in admission should not lead the clinician to overlook the underlying dissociative process, and associated traumatic experiences among these patients.
The purpose of the study was to examine psychopathological traits and psychiatric co-morbidities ... more The purpose of the study was to examine psychopathological traits and psychiatric co-morbidities in seekers of cosmetic rhinoplasty. Fifty persons seeking cosmetic rhinoplasty and 50 control subjects were admitted to the study. Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Symptom Checklist-90 [Revised] (SCL-90-R) were administered to people who requested cosmetic rhinoplasty and control subjects. All participants were also screened by the Structured Clinical Interview for DSM-IV-(SCIDI/CV, SCID-II). Thirteen cosmetic rhinoplasty seekers [CRS] (26%) and three control subjects (6%) had at least one psychiatric diagnosis. There was a significant difference between the two groups (p = 0.006). Beck depression inventory (p = 0.002) and BAI (p = 0.046) levels above the cut-off point were significantly higher in the CRS group than in the normal control. Somatoform disorders were statistically higher in the CRS than control group (p = 0.007). Nine CRS (18%) and two contr...
A possible relationship has been suggested between social anxiety and dissociation. Traumatic exp... more A possible relationship has been suggested between social anxiety and dissociation. Traumatic experiences, especially childhood abuse, play an important role in the aetiology of dissociation. This study assesses childhood trauma history, dissociative symptoms, and dissociative disorder comorbidity in patients with social anxiety disorder (SAD). The 94 psychotropic drug-naive patients participating in the study had to meet DSM-IV criteria for SAD. Participants were assessed using the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D), the Dissociation Questionnaire (DIS-Q), the Liebowitz Social Anxiety Scale (LSAS), and the Childhood Trauma Questionnaire (CTQ). Patients were divided into two groups using the DIS-Q, and the two groups were compared. The evaluation found evidence of at least one dissociative disorder in 31.91% of participating patients. The most prevalent disorders were dissociative disorder not otherwise specified (DDNOS), dissociative amnesia, and depersonalization disorders. Average scores on LSAS and fear and avoidance sub-scale averages were significantly higher among the high DIS-Q group (p &lt; .05). In a logistic regression taking average LSAS scores as the dependent variable, the five independent variables DIS-Q, CTQ-53 total score, emotional abuse, sexual abuse, and emotional neglect were associated with average LSAS scores among patients with SAD (p &lt; .05). It is concluded that, on detecting SAD symptoms during hospitalization, the clinician should not neglect underlying dissociative processes and traumatic experiences among these patients.
In this article, it is aimed to review the efficacies of mood stabilizers and atypical antipsycho... more In this article, it is aimed to review the efficacies of mood stabilizers and atypical antipsychotics, which are used commonly in psychopharmacological treatments of bipolar and borderline personality disorders. In this context, common phenomenology between borderline personality and bipolar disorders and differential features of clinical diagnosis will be reviewed in line with the literature. Both disorders can demonstrate common features in the diagnostic aspect, and can overlap phenomenologically. Concomitance rate of both disorders is quite high. In order to differentiate these two disorders from each other, quality of mood fluctuations, impulsivity types and linear progression of disorders should be carefully considered. There are various studies in mood stabilizer use, like lithium, carbamazepine, oxcarbazepine, sodium valproate and lamotrigine, in the treatment of borderline personality disorder. Moreover, there are also studies, which have revealed efficacies of risperidone,...
Abstract
The relationship between Panic Disorder (PD) and dissociation is well known. In this st... more Abstract
The relationship between Panic Disorder (PD) and dissociation is well known. In this study we aimed to investigate whether or not dissociative experiences affect the response to PD drug treatment. For this purpose, standart dose of venlafaxine was preferred for treatment. 63 patients with PD were included in the study. Venlafaxine treatment with increasing dose was administered to each patient during a 10-week period. The Panic Disorder Severity Scale (PDSS) and the Dissociation Questionnaire (DIS-Q) were applied to the patients at the
beginning of the study. Patients were divided into two groups based on DIS-Q scores. PDSS was applied again to both groups at the end of 10-week treatment. No difference between sociodemographic data and PDSS scores of two groups – patients with low DIS-Q scores (b2.5) and high DIS-Q scores (N2.5) – was found at the beginning. At the end of the study, a significant decrease in PDSS scores measured in both groups was detected. However, the decrease in PDSS score for the group with lower DIS-Q score was at a higher percentage (z = −3.822, p = 0.0001). These results depict that dissociative symptoms accompanying PD affect psychopharmacological treatment in a negative way. Reevaluation of dissociative symptoms at the beginning and end of treatment would help in planning personal therapy.
Dusunen Adam: The Journal of Psychiatry and Neurological Sciences, 2013
This article aims to review the effectiveness of mood stabilizers used in the psychopharmacologic... more This article aims to review the effectiveness of mood stabilizers used in the psychopharmacologic treatment of both bipolar disorder and borderline personality disorder. In this context, the overlapping phenomenology of borderline personality disorder and bipolar disorder and the differential diagnosis of clinical features will be also reviewed with the literature.
Both disorders can show common features in terms of diagnosis and overlap in phenomenological perspective. Coexistence of both disorders is quite frequent. The nature of mood shifts, types of impulsivity and the longitudinal course of the disorders should be considered to differenciate them. There are findings on the effectiveness of mood stabilizers such as lithium, carbamazepine, oxcarbazepine, sodium valproate or lamotrigine in the treatment of the borderline personality disorder. The differentiation of borderline personality disorder from bipolar disorder is not easy. A very careful evaluation is required. This differentiation may also be useful in terms of treatment. A greater number of research results are available on the effectiveness of valproate and lamotrigine in the treatment of borderline personality disorder. Findings related to other mood stabilizers are insufficient. In
the treatment of borderline personality disorder, there is not any drug approved by the official authorities. Psychotherapeutic approaches still retain their important place in the treatment. However, symptombased approach is proposed in the use of mood stabilizers.
This study assesses childhood trauma history, dissociative symptoms, and dissociative disorders c... more This study assesses childhood trauma history, dissociative symptoms, and dissociative disorders comorbidity in patients with Panic Disorder (PD). Ninety two psychotropic drug-naive patients with PD, recruited from outpatient clinics in the psychiatry department of a Turkish hospital were involved in the study. Participants were assessed with the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D), Dissociation Questionnaire (DIS-Q), Panic and Agoraphobia Scale (PAS), Panic Disorder Severity Scale (PDSS) and the Childhood Trauma Questionnaire (CTQ). Eighteen (19 %) of the patients with PD had comorbid dissociative disorder diagnosis upon screening with SCID-D. The most prevalent disorders were dissociative disorder not otherwise specified (DDNOS), dissociative amnesia, and depersonalization disorders. Patients with a high degree of dissociation symptoms and dissociative disorder comorbidity had more severe PD than those without (P<0.05). All of the childhood trauma subscales used were correlated with the severity of symptoms of dissociation and PD. Among all subscales, the strongest relationship was associated with childhood emotional abuse. Logistic regression analysis showed that emotional abuse and severity of PD were independently associated with dissociative disorder. In our study, a significant proportion of the patients with PD had concurrent diagnoses of dissociative disorder. We conclude that the predominance of PD symptoms in admission should not lead the clinician to overlook the underlying dissociative process, and associated traumatic experiences among these patients.
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Papers by Mahir Akbudak
The relationship between Panic Disorder (PD) and dissociation is well known. In this study we aimed to investigate whether or not dissociative experiences affect the response to PD drug treatment. For this purpose, standart dose of venlafaxine was preferred for treatment. 63 patients with PD were included in the study. Venlafaxine treatment with increasing dose was administered to each patient during a 10-week period. The Panic Disorder Severity Scale (PDSS) and the Dissociation Questionnaire (DIS-Q) were applied to the patients at the
beginning of the study. Patients were divided into two groups based on DIS-Q scores. PDSS was applied again to both groups at the end of 10-week treatment. No difference between sociodemographic data and PDSS scores of two groups – patients with low DIS-Q scores (b2.5) and high DIS-Q scores (N2.5) – was found at the beginning. At the end of the study, a significant decrease in PDSS scores measured in both groups was detected. However, the decrease in PDSS score for the group with lower DIS-Q score was at a higher percentage (z = −3.822, p = 0.0001). These results depict that dissociative symptoms accompanying PD affect psychopharmacological treatment in a negative way. Reevaluation of dissociative symptoms at the beginning and end of treatment would help in planning personal therapy.
Both disorders can show common features in terms of diagnosis and overlap in phenomenological perspective. Coexistence of both disorders is quite frequent. The nature of mood shifts, types of impulsivity and the longitudinal course of the disorders should be considered to differenciate them. There are findings on the effectiveness of mood stabilizers such as lithium, carbamazepine, oxcarbazepine, sodium valproate or lamotrigine in the treatment of the borderline personality disorder. The differentiation of borderline personality disorder from bipolar disorder is not easy. A very careful evaluation is required. This differentiation may also be useful in terms of treatment. A greater number of research results are available on the effectiveness of valproate and lamotrigine in the treatment of borderline personality disorder. Findings related to other mood stabilizers are insufficient. In
the treatment of borderline personality disorder, there is not any drug approved by the official authorities. Psychotherapeutic approaches still retain their important place in the treatment. However, symptombased approach is proposed in the use of mood stabilizers.
The relationship between Panic Disorder (PD) and dissociation is well known. In this study we aimed to investigate whether or not dissociative experiences affect the response to PD drug treatment. For this purpose, standart dose of venlafaxine was preferred for treatment. 63 patients with PD were included in the study. Venlafaxine treatment with increasing dose was administered to each patient during a 10-week period. The Panic Disorder Severity Scale (PDSS) and the Dissociation Questionnaire (DIS-Q) were applied to the patients at the
beginning of the study. Patients were divided into two groups based on DIS-Q scores. PDSS was applied again to both groups at the end of 10-week treatment. No difference between sociodemographic data and PDSS scores of two groups – patients with low DIS-Q scores (b2.5) and high DIS-Q scores (N2.5) – was found at the beginning. At the end of the study, a significant decrease in PDSS scores measured in both groups was detected. However, the decrease in PDSS score for the group with lower DIS-Q score was at a higher percentage (z = −3.822, p = 0.0001). These results depict that dissociative symptoms accompanying PD affect psychopharmacological treatment in a negative way. Reevaluation of dissociative symptoms at the beginning and end of treatment would help in planning personal therapy.
Both disorders can show common features in terms of diagnosis and overlap in phenomenological perspective. Coexistence of both disorders is quite frequent. The nature of mood shifts, types of impulsivity and the longitudinal course of the disorders should be considered to differenciate them. There are findings on the effectiveness of mood stabilizers such as lithium, carbamazepine, oxcarbazepine, sodium valproate or lamotrigine in the treatment of the borderline personality disorder. The differentiation of borderline personality disorder from bipolar disorder is not easy. A very careful evaluation is required. This differentiation may also be useful in terms of treatment. A greater number of research results are available on the effectiveness of valproate and lamotrigine in the treatment of borderline personality disorder. Findings related to other mood stabilizers are insufficient. In
the treatment of borderline personality disorder, there is not any drug approved by the official authorities. Psychotherapeutic approaches still retain their important place in the treatment. However, symptombased approach is proposed in the use of mood stabilizers.