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Yayın Alcohol-dependent patients attempting and not attempting suicide: a comparison(CAMBRIDGE UNIV PRESS, 2004) Pektas, O; Mirsal, H; Kalyoncu, A; Unsalan, N; Beyazyurek, MBackground: Alcohol dependence is a psychiatric disorder associated with an increased risk of suicidal behaviour. This is also associated with an increased number of suicide risk factors. Objective: The current study examined the sociodemographic and clinical characteristics of a number of alcohol-dependent patients who attempted suicide. Methods: We studied a consecutive series of 377 alcohol-dependent patients in our in-patient clinics. Their alcohol-use histories were assessed through semistructured interviews. The Suicidal Behaviors Questionnaire, the Childhood Trauma Questionnaire, the Michigan Alcoholism Screening Test and the Hamilton Depression Rating Scale were administered to all patients. Serum total cholesterol levels, mean corpuscular volume, the liver enzymes gamma glutamyl transferase, aspartate aminotransferase and alanine aminotransferase were routinely measured. In the statistical analyses, Student's t-test and chi-squared tests were applied. Results: Of the 377 alcohol-dependent patients, 89 (23.6%) had histories of attempted suicide. Thirty-four (42.5%) of the 80 female alcohol-dependent patients and 55 (18.5%) of the 297 male alcohol-dependent patients had attempted suicide; this gender difference was statistically significant (chi(2) = 27.7, P < 0.001). A greater proportion of the suicide attempters than of the non-attempters met the Diagnostic Statistical Manual IV criteria for another psychiatric disorder (60.6%, n = 54, vs. 40.6%, n = 117; chi(2) = 14.8; df = 6; P < 0.05). The difference of total cholesterol levels between female (mean = 144.0, SD = 58.3; mean = 158.0, SD = 83.9; t = 4.5; P < 0.05) and male (mean = 133.7, SD = 50.5; mean = 163.6, SD = 69.7; t = 11.7; P < 0.01) attempters and non-attempters was statistically significant. Conclusion: These results suggest that suicide attempts in alcohol-dependent patients are associated with more profound biopsychosocial pathology and decreased serum cholesterol levels.Yayın Childhood trauma in alcoholics(OXFORD UNIV PRESS, 2004) Mirsal, H; Kalyoncu, A; Pektas, O; Tan, D; Beyazyurek, MAims: Many studies have been conducted to evaluate the relationship between childhood trauma and alcoholism. In this study 80 alcoholics were chosen according to their hospitalization order. The control group consisted of 60 subjects, with no history of alcohol use, matched with the patient group in age and sex. Methods: A sociodemographic and clinical data form, a questionnaire focusing on traumatic life experiences in childhood and The Childhood Trauma Questionnaire, Hamilton Depression Rating Scale, and Hamilton Anxiety Rating Scale were applied to both groups. Results: Significant differences were found between the two groups on traumatic life experiences in childhood. Results suggested that childhood trauma positively correlates with anxiety and affective symptoms among alcoholics. Conclusions: Further studies are needed concerning this issue.Yayın Major depressive disorder with psychotic features induced by interferon-alpha treatment for hepatitis C in a polydrug abuser(SAGE PUBLICATIONS LTD, 2005) Kalyoncu, OA; Tan, D; Mirsal, H; Pektas, O; Beyazyurek, MInfectious diseases, especially hepatitis C, are prevalent among drug abusers. Interferon-alpha (IFN-alpha) is the pharmacological treatment of choice for this condition. Patients being treated with IFN-alpha can be expected to experience such psychiatric side-effects as development of depression, mania, irritability, changes in personality, hallucinations or delirium. In addition, certain patients are considered to be at greater risk of developing neuropsychiatric side-effects. Individuals meeting the following criteria are particularly vulnerable: over 40 years of age; having central nervous system abnormalities; a previous neurological or psychiatric history; a past familial psychiatric history; use of narcotics or having alcohol or substance use disorders; being HIV-positive; coadministration of other cytokines; receiving high doses of IFN-alpha (> 6 million units). We report the case of a 29-year-old patient with chronic non-active hepatitis C, a previous psychiatric history of polydrug abuse (cannabis, heroin and illegal use of the psychotropic drug biperiden) and anxiety disorder. Two weeks after the initiation of IFN-alpha treatment, he developed fatigue, sleeplessness and persecutory delusions. The patient responded partially to the discontinuation of the IFN-alpha treatment. Due to the presence of three risk factors in this patient, he was considered to belong to the group of patients being 'at high risk' of developing neuropsychiatric side-effects. This is the first case report of major depressive disorder with psychotic features in such a 'high-risk patient' This case report may prompt other research by showing the importance of the close monitoring, and the prevention of the progression of IFN-alpha-related psychiatric disorders in 'at high-risk patient'.Yayın Prediction of viability by pulsed wave Doppler tissue sampling of asynergic myocardium during low dose dobutamine challenge(W B SAUNDERS CO LTD, 2000) Altinmakas, S; Dagdeviren, B; Uyan, C; Keser, N; Bulut, S; Pektas, O…Yayın Prediction of viability by pulsed-wave Doppler tissue sampling of asynergic myocardium during low-dose dobutamine challenge(ELSEVIER SCI IRELAND LTD, 2000) Altinmakas, S; Dagdeviren, B; Uyan, C; Keser, N; Gumus, V; Pektas, ODobutamine stress echocardiography is widely used to predict reversible left ventricular dysfunction, but evaluation with this method is subjective. Pulsed-wave tissue Doppler imaging is a new technique that allows to obtain quantitative data on wall motion velocities of different myocardial segments through sample-volume placement. Therefore, this tool in combination with DSE may be suitable for identifying viability in asynergic myocardium. To evaluate this, in 40 patients (mean age 57+/-9) with resting dyssynergy (akinesis in 52, hypokinesis in 30) baseline wall motion scores and tissue Doppler variables were collected before and after 5 min infusion of 10 mu g/kg per min dobutamine. Forty-six of 82 segments were classified as viable (a reduction in segmental score of at least one grade) according to follow-up echocardiography that was performed 4 weeks after revascularization. While myocardial S velocity percent increase in viable segments was 45+/-10, the increase was 25+/-12 in necrotic segments (n=36) during 10 mu g dobutamine infusion (P=0.0001). Assuming 35% as a cut-off for viability the increase in S velocities by DSE yielded an 89% sensitivity and 86% specificity for predicting post-revascularization functional recovery. In conclusion, pulsed-wave tissue Doppler imaging of asynergic myocardium during dobutamine stress echocardiography can identify the viability quantitatively. (C) 2000 Elsevier Science Ireland Ltd. All nights reserved.Yayın Use of lamotrigine to augment clozapine in patients with resistant schizophrenia and comorbid alcohol dependence: a potent anti-craving effect?(SAGE PUBLICATIONS LTD, 2005) Kalyoncu, A; Mirsal, H; Pektas, O; Unsalan, N; Tan, D; Beyazyurek, MComorbid alcohol dependence is common in patients with schizophrenia and is associated with a variety of serious adverse consequences. Although case reports exist concerning the positive impact of lamotrigine addition on clozapine treatment in resistant schizophrenia, a review of the literature fails to document any evidence regarding a combination of the two in the treatment of patients with schizophrenia and comorbid alcohol dependence. In the present study, we present three cases in which patients with resistant schizophrenia and comorbid alcohol use disorder were given lamotrigine to augment clozapine. Our findings suggest that clozapine plus lamotrigine may be helpful inreducing alcohol consumption and craving among patients with schizophrenia and comorbid alcohol dependence.
