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Öğe Association between latent toxoplasmosis and clinical course of schizophrenia-continuous course of the disease is characteristic for Toxoplasma gondii-infected patients(Czech Academy of Sciences, 2015) Çelik T.; Kartalci S.; Aytaş O.; Akarsu G.A.; Gözükara H.; Ünal S.The aim of the present study was to investigate the association between various clinical aspects of schizophrenia and seropositivity against Toxoplasma gondii (Nicolle et Manceaux, 1908). We selected 94 patients with schizophrenia and investigated the seropositivity rate for anti-T. gondii IgG antibodies by ELISA. Clinical parameters of schizophrenic patients such as illness type and status, clinical course, awareness of the illness and need for electroconvulsive therapy (ECT) were compared with their serological status. Anti-T. gondii IgG antibodies were detected in 43 (46%) of schizophrenic patients. Chronic patients had a rate of 34 (72%) seropositivity, whereas 9 (22%) of the patients with partial remission showed evidence of latent toxoplasmosis. Of continuous patients, 35 (81%) were found to be seropositive and this rate was significantly more than in the other groups. The rate of latent toxoplasmosis was detected significantly higher in patients who lack awareness of schizophrenia (36, i.e. 72%) than the patients who were aware of their illnesses (7, i.e. 16%). Anti-T. gondii IgG antibodies were detected in 38 (70%) of ECT performed patients while this percentage was 13% in the ones who had never been treated with ECT. This difference was also statistically significant. We showed that Toxoplasma-infected subjects had 15× higher probability of having continuous course of disease than Toxoplasma-free subjects. Our results put forth the possibility of latent toxoplasmosis to have a negative impact on the course of schizophrenia and treatment response of schizophrenic patients. © Institute of Parasitology, Biology Centre CAS.Öğe Characteristics of psychotic patients don't come to appointments(2006) Ünal S.; Çakil G.; Elyas Z.Objective: In this study we aimed to determine the reasons why the patients don't come to outpatient follow-up in schizophrenia and other psychotic disorders. Methods: The sociodemographic features of the psychotic patients who had inpatient treatment at our clinic between the years 1998 and 2004; and didn't come to their follow-up examination after being discharged, their variables about the illness, the reasons why they didn't come to our clinic were tried to be determined by means of file scanning and telephone questionnaire. Results: Seventy-one of 118 patients whom we determined that didn't apply to our clinic to receive ambulatory treatment were reached. The mean age of the patients was 34.89±10.08 (median=34, min-max=17-76). Seventy-one of them (%62.8) were male, 42 of them (%37.2) were female. A large proportion of our patient group consisted of the people who had schizophrenia diagnosis (%72.6). Among the reasons why the chronic psychotic patients didn't come to our clinic for treatment were environmental problems such as not to be able to get a patient transfer paper, transportation difficulty, the patient's living in a village, not to have a family member to bring him/her to the hospital, the patient's not creating problems for his/her family. The reasons why the patients use their drugs irregularly or don't use were mostly about not believing the drugs to be useful and side effects of the drugs. It had also a negative factor in the attitude of treatment team that the patients didn't have enough information about their illnesses. Discussion: It is important for the process of the illness that chronic psychosis patients continue their treatment regularly after being discharged. Many factors hindering the ambulatory treatment are factors which are able to be improved. Conclusion: Cooperation with other psychiatry clinics and village clinics, to give information to the patient and his/her family about the process, symptoms and treatment of the illness are the precautions which will increase the rate in continuing the treatment.Öğe Effect of risperidone on auditory event-related potentials in patients with chronic schizophrenia(2005) Özişik H.I.; Özcan Y.; Kizkin S.; Ünal S.; Özcan C.Objective: Cognitive deficits are major aspect and cause of disability in schizophrenia. Several neuropsychological studies have reported significant effects of atypical neuroleptics on cognitive functioning in patients with schizophrenia. Event-related potentials are objective assessments of human information processing, and provide a reliable method for evaluating the effects of psychotropic drugs. Methods: The study sample consisted of 7 subjects. They were outpatients at the Department of Psychiatry, İnönü University Hospital. The patients were diagnosed as having schizophrenia according to the DSM-IV on the basis of a structured psychiatric interview. The subjects were treated with risperidone. In order to examine the effects of risperidone on cognitive impairment in schizophrenia, event-related potentials (ERPs) were recorded before and after 6 weeks treatment ERPs were recorded using a standard oddball paradigm. The amplitudes and latencies of P300 component were measured in ERPs for target stimuli in the oddball task. Results: P300 latencies in Fz, Cz and Pz regions and amplitudes in Fz and Cz regions significantly decreased with risperidone treatment. Conclusion: These findings suggest that risperidone may speed up the information processing in schizophrenic patients.Öğe Efficacy of risperidone on positive and negative symptoms of schizophrenia and memory functions(2000) Özcan Y.; Özişik R.I.; Ünal S.; Özcan M.E.Objectives: Symptoms due to cognitive impairment are common in patients with schizophrenia. Those are present before the onset of schizophrenia and are persistent during the course. It is important to relieve these symptoms as cognition is essential to maintain social functioning. Thus, the drugs which enhance cognitive, positive and negative symptoms of schizophrenia are desirable. In this context, the aim of this study has been to evaluate the efficacy of risperidone, a new atypical antipsychotic. Method: This study included twenty patients with schizophrenia. Diagnoses were made according to DSM-IV. Prior to institution, scores for BPRS, SANS, SAPS and Wechsler Memory Scale WMS-R were obtained. The patients received risperidone orally at a mean dosage of 5.60±1.23 mg daily. The scores obtained again at the end of week 6. Results: The differences between pretreatment and post treatment scores of BPRS, SAPS and SANS were statistically significant (p<0.001). All sub test scores in Wechsler Memory Scale (WMS-R) test were also statistically significant (p<0.001). Correlation analysis among variables showed negative correlation between BPRS, SAPS and logical memory and post treatment memory control and positive correlation between pretreatment mental control, figural memory and verbal paired associates and the same variables. Conclusions: The patients who were treated with risperidone in this study showed statistically significant improvement in positive and negative symptoms and cognitive functions. Improved cognitive functions were mental control, logical memory and visual reproductions. These results suggest an important role in both relieving positive and negative symptoms and improving cognitive functions for risperidone in patients with schizophrenia.Öğe Nonsynaptic neurotransmission(2003) Akyol Ö.; Ünal S.Information in the brain is transmits by both synaptic and nonsynaptic neurotransmission (NSN). NSN includes the diffusion through the extracellular fluid of neurotransmitters released from nonsynaptic varicosities and high-affinity transmitter receptors and transporters. This high-affinity uptake system is the target of many neurotransmitters such as noradrenaline, dopamine, serotonin, acetylcholine and nitric oxide (NO) and also many drugs such as tricyclic antidepressants, psychostimulants serotonin reuptake blockers, and anticonvulsants. NSN also includes the diffusion of substances such as NO and carbon monoxide (CO) through both extracellular fluid and cellular membranes. It has been shown that NO can influence the function of uptake carrier systems. In this paper, the possible roles of NSN in the brain activity and drug actions are reviewed.Öğe The role of gender in psychotic illness perception and help-seeking behavior(2006) Kaya Y.; Ünal S.Objective: The aim of this study was to investigate the role of gender in psychotic illness perception, causal attributions and suggested treatment options. Methods: Case scenario method was used in this cross-sectional study of 172 subjects. A single psychotic illness scenario was presented to male and female subjects as male and female patients, and open-ended questions were asked regarding the illness scenario. Sociodemographic data of subjects were evaluated with descriptive statistical methods. The percentages of responses to questions in the sample were calculated. Chi-square test was utilized to investigate the presence or absence of a statistical significance between subjects' perceptions of signs, causal attributions and suggested treatment options to the patients on the basis of gender. Results: The condition of the person in the scenario was attributed rather to the life problems by subjects with higher education (>11 years) and income (>600 NTL/month) levels (p=0.03) when both male and female subjects were evaluated together. While the male subjects described the condition of the person in the scenario as "sick" (31.4%) and "having psychological problems" (68.6%), these percentages were 41.9% and 58.1%, respectively, in female subjects. Both of the subject groups described both male and female persons in the scenario mostly as "having psychological problems". The source of problem in the scenario was attributed, both by male and female subjects, to marriage and interpersonal relationships (p=0.00) for female case, and work/economic problems (p=0.00) for male case. Conclusion: Our findings suggest that Turkish population in Malatya sample considers the patient gender as an important variable in psychotic illness definition, causal attributions and suggesting treatment options.
