2018-04-01, KILIÇ, Alperen, Ozturk, AHMET, Deveci, ERDEM, Kirpinar, Ismet, ÖZTÜRK, AHMET, DEVECİ, ERDEM, KIRPINAR, İSMET

Hyperprolactinemia is characterized by abnormally increased serum prolactin levels. Menstrual irregularities and hyperprolactinemia can be caused by a variety of medical conditions as well as due to the use of some psychopharmacological drugs, namely antipsychotics; it can also develop during antidepressant treatment. Bupropion is an antidepressant functioning via the inhibition of noradrenaline and dopamine reuptake. The endocrine and sexual adverse events of this agent are rare. In the literature, only one case reporting hyperprolactinemia or galactorrhea caused by bupropion use is available. Here, we present the case of a patient diagnosed with depressive disorder and receiving venlafaxine, who developed hyperprolactinemia and oligomenorrhea after the addition of bupropion the ongoing treatment and showed serum prolactin levels decreased to normal ranges shortly after the discontinuation of bupropion.

2012-03-01T00:00:00Z, Kirpinar, Ismet, TEPELI, Isik Ozturk, GÖZÜM, SEBAHAT, Pasinlioglu, Turkan, KIRPINAR, İSMET

Objective: The studies investigating the prevalence and incidence of postpartum depression (PPD), as well as its nosologic status have controversial results. This article is part of a prospective, epidemiological study concerning postpartum depression in Erzurum City, Eastern Turkey. The present study focuses on the prevalence and incidence of PPD at sixth weeks after delivery and its diagnostic distribution according to DSM-IV. Methods: Four hundred and seventy-nine pregnant women in their third trimester were arranged to be visited by trained community midwives at 7-10 days and sixth weeks after delivery. Data were collected by use of the questionnaires on detailed sociodemographic and health information at each visit and the participitants filled out the Edinburgh Postpartum Depression Scale (EPDS) at six weeks after delivery. Finally, mothers who had PPD diagnosis according to EPDS were visited by a psychiatrist in their homes where the SCID was administered to make a DSM-IV diagnosis and determine whether the depression occurred before or after delivery. Results: The prevalence rate of PPD measured by EPDS was 14% in this population. The incidence of PPD was estimated as 6% with clinical interviews. Most of the depressed mothers (74.0%) were diagnosed as major depressive disorder according to DSM-IV, but there were some other depressive states too. Conclusion: The prevalence and incidence rates of PPD do not appear to be significantly different from those of non-childbearing women. PPD should not be seen as a specific clinical entity as far as its diagnostic distribution is concerned. (Anatolian Journal of Psychiatry 2012;13:16-23)

2011-06-01T00:00:00Z, KATIRCI, Yavuz, Kandis, Hayati, Aslan, Sahin, Kirpinar, Ismet, KIRPINAR, İSMET

Neuropsychiatric sequelae may be observed in the late phases of carbon monoxide (CO) intoxication. Establishing a link between CO-related neuropsychiatric disorders and associated risk factors may decrease morbidity and mortality by means of appropriate treatment and counseling. The aim of the present study was to determine the relationship between neuropsychiatric outcomes of CO intoxication and demographic and clinical variables. Thirty patients who presented with CO intoxication and had no known neuropsychiatric disease, and 30 healthy controls were included. Physical examinations and laboratory tests were performed. Following the 1st therapy, they underwent mental and psychiatric tests 5 times (the time of discharge, during the 1st week, and during the 1st, 3rd, and 6th months). They underwent cerebral magnetic resonance imaging (MRI) at the end of the 1st month. They were evaluated by cognitive function tests at the 6th month. Lesions relevant to CO intoxication were detected in 46.7% of the patients via cranial computed tomography and in 13.3% via MRI. Evaluation of psychiatric tests revealed a clear decrease in cognitive functions, such as immediate memory, learning, reaching the criterion, spontaneous recall, attention, visual memory, and logical memory. It was found that the patients had anxiety within the 1st month, and the frequency of anxiety reached to the value of the control group by the end of the 6th month. In conclusion, we suggested that CO intoxication might lead to neuropsychiatric disorders. Our results emphasized that in addition to standard treatment, neuropsychiatric evaluation should also be performed in patients with CO intoxication.

2016-12-01, Kirpinar, Ismet, KIRPINAR, İSMET

Delirium is most common neuropsychiatric disorder that affects patients in surgical and internal medicine clinics. It is defined as a transient, usually reversible organic mental disorder that has a rapid onset and fluctuating course. Clinically, delirium is an acute or subacute organic mental syndrome that is characterized by a disturbance in attention (reduced ability to direct, focus, sustain, and shift attention), awareness (reduced orientation to the environment), and other cognitive abilities (e.g., memory deficit and disorientation) and is not better explained by preexisting, established, or other evolving neurocognitive disorders. Studies have found that between 10% and 20% of all adult inpatients are diagnosed with delirium and that it occurs in up to 50% of elderly inpatients. Delirium itself is not a disease but rather a clinical syndrome, which results from an underlying disease. There is evidence from the history, physical examination, or laboratory findings that the disturbance is a physiological consequence of an underlying medical condition, substance intoxication or withdrawal, use of a medication, or a toxin exposure, or it is a combination of these factors. Accurate identification of underlying causes and risk factors is essential in early stage diagnosis and treatment. Treatment of delirium requires the treatment of the underlying causes. Psychotropic medications are used to comfort patients or enable better patient management. This study aims to review the clinical characteristics, etiological and risk factors, and different methods to obtain an accurate diagnosis and treatment of delirium.

2013-05-01, YAZICI, Esra, YAZICI, Ahmet Bulent, Aydin, Nazan, Orhan, Asuman, Kirpinar, Ismet, Acemoglu, Hamit, KIRPINAR, İSMET

Personality and behavioral changes in epilepsy are well documented. However, neither the quantitative characteristics nor the etiology of these changes is clear yet. Cloninger has developed a psychobiological personality model that provides a way to evaluate personality in a dimensional way. This study examined the relationship between epilepsy and Cloninger-s dimensional psychobiological personality model. A total of 73 epilepsy outpatients and 79 healthy controls were examined using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis I Disorders, the Turkish version of the Temperament and Character Inventory, and an epilepsy questionnaire. Epilepsy patients had higher harm avoidance ( HA) and lower persistence, self-directedness (SD), and cooperativeness scores than healthy controls did. In epileptic subjects, there was no correlation between age and duration of epilepsy. Subjects with partial seizures had higher HA scores and lower SD scores than generalized ones. Comorbid depression was represented with lower SD scores. In multiple linear regression models, only major depressive disorder predicted lower scores of SD. This study confirms specific personality changes among epileptics according to Cloninger-s dimensional personality model and indicates a relationship between the characteristics of epilepsy and psychiatric comorbidity.

2012-09-01, YAZICI, Esra, YAZICI, Ahmet Bulent, Aydin, Nazan, Varoglu, Asuman Orhan, Kirpinar, Ismet, KIRPINAR, İSMET

Affective temperaments in epilepsy

2012-09-01, Deveci, ERDEM, Ozan, Erol, Gulec, Mustafa, Kirpinar, Ismet, DEVECİ, ERDEM, KIRPINAR, İSMET

Objective: To assess clinical depression and severity of depression symptoms early after a first acute myocardial infarction (MI). Methods: Data was collected with a structured questionnaire including sociodemographic characteristics and Beck Depression Inventory (BDI). The questionnaire was applied to the 100 patients, who had suffered from first MI, after they were transferred to the ward from the coronary intensive care unit. Results: The mean age of the patients was 58.4 +/- 9.9 years, of whom 86.0% were male and 95.0% were married. The mean education duration was 4.6 +/- 4.1 years; the rate of illiterate and literate patients was 34.0% and the rate of patients graduated from primary school was 42.0%. Forty-seven percent of patients had a previous concomitant physical disease. Forty-three percent patients obtained a BDI score lower than 10, while 31.0% had a score of >= 17. A positive significant, but weak correlation was observed between BDI scores and age. The rate of patients with clinical depression (BDI score >= 17) was significantly higher in females as compared to males (64.3% and 25.6%, respectively, p<0.05). Conclusions: The diagnosis of post-MI depression may be difficult because of the non-specific complaints. Female gender was found to be a significant independent variable predicting the presence of depression symptoms and severity during the post-MI period. It would be beneficial to routinely investigate the presence and intensity of depression symptoms after MI. (Anatolian Journal of Psychiatry 2012; 13:179-183)

2014-09-01, Ozturk, AHMET, Deveci, ERDEM, DURSUN, Ali Emre, Soyucok, Etem, Kirpinar, Ismet, DEVECİ, ERDEM, KIRPINAR, İSMET

2018-06-01, GÖRMEZ, AYNUR, Kurtulmus, AYŞE, Kirpinar, Ismet, KURTULMUŞ, AYŞE, KIRPINAR, İSMET

2010-09-01T00:00:00Z, Ozan, Erol, Deveci, ERDEM, Kirpinar, Ismet, TEHLI, Ozkan, DEVECİ, ERDEM, KIRPINAR, İSMET

Behavioral syndromes observed with frontal lobe injury involve lesions of the circuits, connecting the frontal lobe to subcortical structures. Dorsolateral prefrontal circuit lesions result in executive function deficits, orbitofrontal circuit lesions result in disinhibition and impulsivity, and abulia (apathy and amotivation) occur with injury to the anterior cingulate circuit. Thirty-nine years-old female patient was evaluated in our outpaient clinic due to experiencing anosmia for the past two years and headache which appeared a few months after this complaint. In addition to these complaints, the patient reported apathy, anhedonia, lack of energy, inability to perform household chores and increased sleep need for the past 1.5 years. Lately, the patient also reported having blurred vision and had an incidence of urinary incontinence during sleep. The clinical presentation was compatible with anterior cingulate syndrome due to a large olfactory groove meningioma. Depending on the data, we were motivated to review the frontal lobe syndrome and meningiomas, especially the ones originating from the olfactory groove. (Anatolian Journal of Psychiatry 2010; 11:279-284)