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    An Optical Coherence Tomography Study that Supports the Neurovascular Basis of Schizophrenia Disease
    (Aves, 2022) Kurt, Aydin; Zor, Kursad Ramazan; Kucuk, Erkut; Yildirim, Gamze; Ersan, Etem Erdal
    Objectives: Spectral domain optical coherence tomography (SD-OCT) is a non-penetrating, quick, and practical device which enables measurement of the chorioretinal layers. In this study, our purpose was to investigate the retinal nerve fiber layer (RNFL) and choroidal thickness in schizophrenia patients, using SD-OCT, and compare the -findings with those of the control group. Methods: For the study, 44 patients with a diagnosis of schizophrenia, and 41 age- and gender-matched healthy controls were enrolled. Both eyes of each participant were-evaluated. RNFL was measured and analyzed automatically with optical coherence tomography. Scans for choroidal thickness were obtained with the enhanced depth imaging mode of the SD-OCT device and measured manually. Results: The average age of schizophrenia patients was 47.82, and it was 45.5 for the control group. The mean illness duration of the patients was 24.79 years. According to the results of this study, all choroidal measures (nasal, subfoveal, and temporal) of both eyes, and the RNFL thickness of schizophrenia patients, were significantly thinner than that of healthy controls. The chorioretinal measures of both eyes were similar. The results showed that a weak negative correlation was present between illness duration and choroidal diameter. Conclusion: In addition to demonstrating the thinning of RNFL in schizophrenia patients, as frequently reported in the literature, the results of this study show, for the first time, that choroidal thickness is considerably decreased in schizophrenia patients compared to the healthy controls, using SD-OCT. Keeping in mind that the choroid is a vascular layer, these results support the neurovascular hypothesis of schizophrenia.
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    COMPARISON OF HOSPITALIZATION RATE AND SOCIAL FUNCTIONING OF PATIENTS RECEIVING COMMUNITY MENTAL HEALTH SERVICE AND OUTPATIENT PSYCHIATRY POLICLINIC
    (Medicinska Naklada, 2021) Kurt, Aydin; Ersan, Etem Erdal
    Background: This study aimed to compare the hospitalization rates and social functioning of patients receiving Community Mental Health Center (CMHC) services and those treated in the psychiatry policlinics of hospitals. Subjects and methods: A total of 145 patients who were diagnosed with schizophrenia or schizoaffective disorder according to DSM-V criteria were included in the study. Of them, 81 received CMHC services at least for one year (CMHC group) and 64 were followed-up in psychiatry policlinics (hospital group). A personal information form containing socio-demographic and disease/treatment characteristics and hospitalization counts in the last year, Social Functioning Assessment Scale (SFAS) and Positive and Negative Syndrome Scale (PANSS) were used to collect data. The hospital group received antipsychotic medication therapy while a semi-structured psycho-social intervention program combined with antipsychotic drug therapy was applied in the CMHC group. The hospitalization counts, SFAS and PANSS scores of the groups were compared and the correlation of related factors were evaluated. Results: Hospitalization rates were 0.21 +/- 0.56 in the CMHC group and 1.03 +/- 1.31 in the hospital group. The mean hospitalization rate was significantly lower in the CMHC group (p<0.001). The mean scores for the overall SFAS and its interpersonal relationships and entertaining subscale; were significantly higher in the CMHC. The mean overall PANSS scores were 84.23 +/- 15.28 and 99.50 +/- 15.99 in the CMHC and hospital groups, respectively (p<0.05). There was a moderate positive relationship between hospitalization rates and all PANSS scores. Conclusions: CMHC services led to a serious decrease in hospitalization rates, increased the psychosocial functioning of patients and improved their compliance to treatment. Transition to a community-based mental health model should be accelerated for holistic treatment. Further longitudinal studies with a control group should be conducted.
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    Comparison of self-stigma and subjective recovery status of patients receiving Community Mental Health Service and outpatient psychiatry policlinic
    (Kare Publ, 2021) Kurt, Aydin; Ersan, Etem Erdal; Savas, Ipek
    [Abstract Not Available]
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    Efficacy of automatic pupillometry as a screening technique to detect autonomic dysfunction in bipolar disorder
    (Taylor & Francis Ltd, 2023) Bicer, Gamze Yildirim; Kurt, Aydin; Zor, Kursad Ramazan
    BackgroundThe aim of this study was to compare the static and dynamic pupillary responses of bipolar patients with healthy controls. In addition, pupillary response differences between mania, depression and remission stages were investigated.MethodsThe bipolar patient group consisted of 39 eyes of 39 patients with 13 patients in each of the stages: mania, depression and remission. The control group consisted of 39 eyes of 39 healthy volunteers. After the ophthalmic examination, static and dynamic pupillometry measurements were made. The mean pupil dilatation speed was calculated according to dynamic measurements. Static pupillometry measurements including scotopic, mesopic and photopic pupil diameters; the first dynamic measurements at 0th second and pupillary dilatation speed were used for statistical analysis.ResultsThere was no difference static and the first dynamic pupillometry measurements between the bipolar and control groups (p > 0.05 for all parameters), but there was a significant difference in mean pupil dilatation speed (p = 0.041). No significant differences were found between the 3 groups for all static and the first dynamic pupillometry measurements and the mean pupil dilatation speed (p > 0.05).ConclusionStatic and the first dynamic measurements of bipolar patients were not different from healthy controls. The mean pupil dilatation speed of bipolar patients was significantly lower, but this difference had a low effect size.
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    Evaluation of Glucagon-like Peptide-1, Adropin, and Desnutrin Levels and Related Factors in Patients with Bipolar Disorder
    (Aves, 2021) Ersan, Serpil; Kurt, Aydin
    Objective: It is known that impaired energy metabolism contributes to the neuropathology of bipolar disorder (BD). This study aimed to compare the levels of glucagon-like peptide-1 (GLP-1), adropin, and desnutrin, which have many metabolic functions besides the regulation of energy metabolism, between patients with BD and healthy controls and to investigate the related factors. Methods: In the study group, 73 age- and sex-matched participants were included. Of them, 35 were patients diagnosed with BD and 38 were healthy individuals. In the blood samples, in addition to routine biochemistry lipid parameters, the levels of adropin, desnutrin, and GLP-1 were determined. Results: Adropin, desnutrin, and GLP-1 levels were significantly lower in patients with BD than in healthy controls (P < 0.001). In contrast, body mass index, total cholesterol, triglyceride, and low-density lipoprotein levels were significantly higher in patients with BD than in healthy controls (respectively P < 0.001, P= 0.001, P= 0.002, P= 0.001). It was observed that adropin levels decreased significantly as the duration of the disease increased. Conclusion: The low levels of adropin, desnutrin, and GLP-1 that we determined in patients with BD indicate that these peptides may be important in BD pathophysiology.
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    Optical Coherence Tomography Findings in Bipolar Disorder Patients and the Related Factors
    (Aves, 2023) Kurt, Aydin; Zor, Kuersad Ramazan; Bicer, Gamze Yildirim; Kuecuek, Erkut; Ersan, Etem Erdal
    Background: This study's purpose is to determine the effects of current episode and the mood stabilizers on chorioretinal layer thicknesses of bipolar disorder (BD) patients using spectral-domain optical coherence tomography (SD-OCT). Methods: Sixty-seven patients were diagnosed with BD I and using lithium (Li) or valproic acid (VPA), of whom 20 were manic, 24 were depressive, and 23 were in remission, and 49 healthy individuals were included in the study. Peripapillary retinal nerve fiber layer (RNFL), ganglion cell layer, and macular thicknesses of the participants were measured automatically using SD-OCT, and their choroid layer thicknesses were measured manually using the depth imaging mode of SD-OCT. Statistical analysis of the data was performed using Statistical Package for the Social Sciences version 23.0. Results: The patient group's mean age was 39.78 +/- 11.78, and the control group's mean age was 42.06 +/- 12.10. The mean disease duration was 13.22 +/- 8.23 in the patient group, and 26 patients were using Li. While peripapillary RNFL thicknesses were lower in the patient group (P < .05), other layer measurements were similar between the groups. Moreover, the episodes experienced by BD patients did not affect chorioretinal SD-OCT measurements. The patients on VPA had significantly lower RNFL thicknesses compared to the control and the Li groups, and all chorioretinal measurements were similar between the Li and the control groups. Conclusion: As a result of the study, it was established that neurodegenerative processes play a role in the pathophysiology of BD and the usage of Li is protective against the neurodegeneration of RNFL. Retinal changes measured with SD-OCT can be used for the diagnosis and prognosis of BD and for evaluating responses to mood stabilizers.
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    Work motivation and related demographic factors in unemployed patients with schizophrenia
    (Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2020) Incedere, Aysel; Yildiz, Mustafa; Kaytaz, Beyza Nur; Abut, Fatma Betul; Sarandol, Asli; Kurt, Aydin; Aydin, Azize Ozgul
    Objective: Working rate in patients with schizophrenia is considerably low. Nonetheless, unemployed patients might have desire to work and look for a job. Identifying the reasons underlying the patients' work motivation and related factors can be instructive for the vocational rehabilitation services. The purpose of this study was to determine the reasons for work motivation and to identify the predictors of motivation in unemployed patients with schizophrenia. Methods: Sociodemographic and working life information of 379 unemployed patients with schizophrenia or schizoaffective disorder diagnosed for at least two years was collected from six different centers. The patients were questioned about their desire to work and its reasons. Having desire to work and job seeking behavior together was considered as work motivation. Patients with and without having work motivation were compared regarding to their sociodemographic information and illness characteristics. Logistic regression analysis was conducted to find the factors predicting the work motivation. Results: The participants' mean age was 42, level of education was nine years, duration of illness was 18 years, and majority consisted of males and single patients. It was found that 33% of the patients were motivated to work. While distinct underlying reasons of the work motivation were found as financial needs (45%) and will for independent living (35%), idea of not being able to deal with the requirements of the job (66%) and not receiving social welfare payment (24%) were dominant in patients who weren't motivated to work. The predictors of work motivation were found as male gender (OR=2.0), having a profession (OR=2.0), having work experience after the illness (OR=1.2), level of education (OR=1.1), and duration of illness (OR=0.9). Conclusion: We found that one-third of unemployed patients with schizophrenia have work motivation as an important finding. The patients may feel more comfortable and motivated to work if they would continue to receive social welfare payment after they started a job. It could be concluded patients who have a profession, high level of education, previous job experience, and who are at the early stage of their illness are suitable candidates for the vocational rehabilitation services.