ISSN 1302-0099 | e-ISSN 2146-7153
TURKISH JOURNAL CLINICAL PSYCHIATRY - Turkish J Clin Psy: 12 (4)
Volume: 12  Issue: 4 - 2009
RESEARCH ARTICLE
1. Attention, Memory and Executive Functions in the Offspring of Schizophrenic Patients
Şahika Gülen Şişmanlar, Ayşen Coşkun, Belma Ağaoğlu, Işık Karakaya, Cavit Işık Yavuz
Pages 161 - 171
Objective: The purpose of this study was to examine the attention, memory and executive functions in the offspring of patients with schizophrenia. Method: Twenty- seven high-risk children of patients with schizophrenia aged between 8-15 years; and 23 children who did not have family history of psychotic disorder were enrolled. Patients with schizophrenia were evaluated using SCID-I. Parents of children in the control group filled SCL-90-R and were evaluated by clinical interview to rule out any psychotic disorder. The diagnoses of psychiatric disorders in all children were established by DSM-IV-based clinical interviews with children and their parents. All children underwent a neuropsychological battery composed of WISC-R, Bender Visual - Motor Gestalt Test, California Verbal Learning Test - Children Version (CVL.T- C), Wisconsin Card Sorting Test (WCST), Stroop Color and Word Test, Category Naming Test, and Visual Memory Span Subtest of Wecshler Memory Scale. Results: The high-risk children possessed impaired performance on the tasks of executive functioning, verbal memory and learning. In the high-risk group impairment was significant on "List-1/5", "long delayed cued recall" (CVL.T-C) and "categories achieved" (WCST) scores, but when psychiatric disorders were controlled, statistical difference between groups on CVL.T-C disappeared. Conclusion: In our study, decreased performance of high-risk group in executive functioning may support neurodevelopmental hypothesis in the etiology of schizophrenia.

2. Cognitive Errors in Adolescents with Anxiety Disorders
Yağmur Suadiye, Arzu Aydın
Pages 172 - 179
Objectives: Anxiety disorders are among the most common psychiatric disorders in the general child and adolescent population and may have significant impact on immediate and long-term social and academic problems. Cognitive models focus on the hypothesis that anxiety disorders can stem from faulty, biased, or negative ways of thinking and the biased processing of information. The purpose of this study was to evaluate the relation between negative cognitive errors and anxiety in adolescents. Method: This study group consisted of 30 cases with anxiety disorders (18 girls+12 boys) between the ages of 12-17 years who were referred to Mersin University Hospital child psychiatry clinic. The first control group consisted of 30 adolescents (11 girls+19 boys) between the ages of 1 2-17 years who had ADHD and conduct disorder diagnoses and the second control group consisted of 35 adolescents (21 girls+14 boys) between the ages of 12-17 years who did not have any psychiatric diagnoses. Data was collected by Negative Cognitive Errors Questionnaire (CNCEQ) and State-Trait Anxiety Inventory for Children- trait anxiety (STAI-C). Results: The statistical analyses revealed significant main effects of group and gender and the interactions groupxgender for only catastrophizing and over generalizing. Group and gender main effects were significant for the selective abstraction. However gender main effect and group x gender interactions were not significant for personalizing. The gender comparisons revealed that the girls had higher catastrophizing, over generalization and selective abstraction scores. No significant gender difference was found in personalizing scores. Conclusion: Further research on the relation between anxiety and specific cognitive processes for children and adolescents is necessary.

3. The Effect of Thyroid Replacement Therapy on Levels of Anxiety and Depression in Subclinical Hypothyroid Patients
Yalçın Yarpuz, Ümit Aydoğan, Oktay Sarı, Aydoğan Aydoğdu, Gökhan Üçkaya, Ayşen Fenercioğlu, Derya Aksu Yarpuz, Kenan Sağlam
Pages 180 - 187
Objective: In our study, we investigated the effectiveness of thyroxin replacement therapy on the levels of anxiety and depression in patients with subclinical hypothyroidisim. Method: Patients with new onset subclinical hypothyroidism and euthyroid control group constituded the subjects of our study. Beck Anxiety and Beck Depression Scales were applied to these participants in the beginning of the study. Patient group was put on Levothyroxin therapy. Thyroid hormone levels were checked before and six weeks after the treatment was started. At the end of the study same psychologic scales were repeated. Results: In the study group, 66 patients were female and 8 patients were male whereas there were 64 female and 8 male subjects in the control group. Average age was 40.87±10.80 year in the study group and 41.61 ±10.33 year in the control group. In female group, there was a significant elevation (p<0.05) in both anxiety and depression scores compared to control group. While there was a significant elevation in depression scores of male patients compared to control group, no difference was found in anxiety scores (p=0.188). In female group comparison of thyroid replacement therapy according to gender, a significant decrease was observed in both anxiety and depression scores after therapy (p<0.05). There wasn't any statistical difference in male group (respectively p=0.68 and p=0.31). Conclusion: Subclinic hypothyroidism related to Hashimoto thyroiditis may be a risk factor for anxiety and depression. Particularly thyroxin replacement therapy in subclinical hypothyroidism may reduce the beck anxiety and depression scores.

REVIEW
4. A New Target for Treatment of Schizophrenia: Agmatine and Brain Polyamine System
Tayfun Uzbay
Pages 188 - 196
Schizophrenia and schizophrenia-like psychosis are the most important psychiatric disorders in the neuroscience. Particularly, schizophrenia affects almost all functions of brain such as perception, cognitive functions, thought and emotion. It is a complex brain disorder that is influenced by several external factors. Despite some significant developments, pharmacotherapy of schizophrenia is still inefficient. Clarifying etiopathogen- esis of schizophrenia and developing new drugs are already the most enterprising area of psychopharmacology. Agmatine, a cationic polyamine, is widely existed in nature and mammals. Agmatine is a new neurotransmitter in brain. It is synthesized in brain, stored in synaptic vesicles and released from the vesicles to synaptic cleft. Then, it binds to receptors such as imidazoline and adrenergic a2. Recently, some articles indicating that agmatine has a role in etiopathogenesis of schizophrenia have been published. There is also additional information such as NMDA antagonism by agmatine implies that there may be a relationship between agmatine and schizophrenia. Results from previous reports indicating elevated levels of other polyamines like spermidine and spermine in patients with schizophrenia support this idea. In this review, possible role of agmatine and other polyamines in diagnosis and treatment of schizophrenia and schizophrenia-like psychiatric disorders has been considered.

CASE REPORT
5. Dystonia During Fluvoxamine Treatment: A Case Report
Bilge Burçak Annagür, Lut Tamam
Pages 197 - 200
Selective serotonin reuptake inhibitors are generally first- choice drugs, particularly in the treatment of depression, anxiety disorder, eating disorder and various psychiatric disturbances, such as impulse control disorder. Acathisia, dystonia, parkinsonism and tardive dyskinesia have been reported as the extrapyramidal system findings associated with use of selective serotonin reuptake inhibitors. Acute dystonia is a psychiatric emergency. It develops due to use of antipsychotics. However, it has also been reported to occur due to use of antiemetics and antidepressants. In this paper, we present a case with dystonia which developed during fluvoxamine treatment in the second month during administration of increased dose on the patient with obsessive compulsive disorder. There is case reports related to the use of fluoksetin in the literature. This case was considered to be noteworthy to publish, in that it occurred during use of fluvoxamine and it has not been reported in the Turkish literature so far. Clinicians should always keep in their mind that there may be extrapyramidal side effects of selective serotonin reuptake inhibitors and should be careful when increasing doses.

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