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Öğe Clinical management, psychosocial characteristics, and quality of life in patients with homozygous familial hypercholesterolemia undergoing LDL-apheresis in Turkey: Results of a nationwide survey (A-HIT1 registry)(Elsevier Science Inc, 2019) Kayikcioglu, Meral; Kuman-Tuncel, Oztem; Pirildar, Sebnem; Yilmaz, Mehmet; Kaynar, Leylagul; Aktan, Melih; Durms, Rana Berru; Gokce, Cumali; Temizhan, Ahmet; Ozcebe, Osman Ilhami; Akyol, Tulay Karaagac; Okutan, Harika; Sag, Saim; Gul, Ozen Oz; Salcioglu, Zafer; Yenercag, Mustafa; Altunkeser, Bulet Behlul; Kuku, Irfan; Yasar, Hamiyet Yilmaz; Kurtoglu, Erdal; Demir, Melis; Demircioglu, Sinan; Pekkolay, Zafer; Ilhan, Osman; Tokgozoglu, LaleBACKGROUND: Homozygous familial hypercholesterolemia (HoFH) is a rare, life-threatening inherited disease leading to early-onset atherosclerosis and associated morbidity. Because of its rarity, longitudinal data on the management of HoFH in the real world are lacking, particularly on the impact the condition has on quality of life (QoL), including the impact of the extracorporeal lipid removal procedure apheresis (LA). METHODS: The A-HIT1 study included 88 patients with HoFH aged >= 12 years receiving regular LA in 19 centers in Turkey. Demographic and disease characteristics data were obtained. For patients aged >= 18 years, additional data on psychosocial status were obtained via the SF-36 score, the Hospital Anxiety and Depression Scale, and a HoFH-specific questionnaire. RESULTS: There was no standardized approach to therapy between centers. Mean (+/-SD) frequency of LA sessions was every 19.9 (+/-14) days, with only 11.6% receiving LA weekly, and 85% of patients were not willing to increase LA frequency. The most common concerns of patients were disease prognosis (31%), and physical, aesthetic, and psychological problems (27.5%, 15.9%, and 11.6%, respectively). Lower age at diagnosis was associated with better QoL, lower anxiety, improved functioning, and greater emotional well-being compared to later diagnosis. CONCLUSIONS: These findings demonstrate that adult patients with HoFH undergoing LA, experience significant impairment of QoL with an increased risk of depression. From patients' point of view, LA is time-consuming, uncomfortable, and difficult to cope with. The speed of diagnosis and referral has a considerable impact on patient well-being. (C) 2019 National Lipid Association. All rights reserved.Öğe Combination therapy in treatment of peripheral diabetic neuropathy with severe pain in an adolescent patient(Wiley-Blackwell Publishing, Inc, 2009) Eyigor, Can; Uyar, Meltem; Pirildar, Sebnem; Coker, MahmutÖğe Effect of COVID-19 Pandemic on Sleep Quality and Mental State of Frontline Pulmonologists(Turkish Neuropsychiatry Assoc-Turk Noropsikiyatri Dernegi, 2022) Haznedaroglu, Damla Isman; Tuncel, Ozlem Kuman; Hepdurgun, Cenan; Pirildar, Sebnem; Basoglu, Ozen K.Introduction: This study aims to determine the sleep quality and its relationship with anxiety and depressive symptoms, working conditions and other factors among the frontline pulmonologists on active duty during the COVID-19 pandemic.Method: An online survey was conducted among pulmonologists in Turkey. The survey link was e-mailed to the members of the professional societies of pulmonologists. The volunteers were asked to fill in questions about their sociodemographics, medical and psychiatric history, working and housing conditions, perceived levels of support during the pandemic, as well as the sleep habits before the pandemic. Also, questions investigating the severity/level of their worries were inquired and they were asked to fill in two scale forms (the Hospital Anxiety Depression Scale and Pittsburgh Sleep Quality Index-PSQI).Results: The sample consisted of 179 pulmonologists who were divided into two groups according to PSQI as good sleepers (PSQI <= 5) and poor sleepers (PSQI >5). It was observed that 59.2% of the participants had poor sleep quality during the pandemic. Being anxious (p<0.0001, Odds ratio [OR]=0.139, 95% Confidence Interval [CI] [0.052-0.372]), working in intensive care unit (p=0.046, OR=2.363, 95% CI [1.015-5.497]), worry level about excessive increase of the number of patients above the capacity of the institution they worked in (p=0.018, OR=1.755, 95% CI [1.102-2.794]) and being dissatisfied with ones' sleep before the pandemic (p<0.016, OR=0.272, 95% CI [0.094-0.786]) were found to be the main factors that negatively affected the quality of sleep of pulmonologists during the pandemic.Conclusion: More than half of the pulmonologists in our sample group had low sleep quality during the pandemic. For establishing a good sleep regime for clinicians, its crucial to consider certain interventions on the affecting factors.Öğe Effect of educational and supportive interventions on positive airway pressure therapy adherence in patients with obstructive sleep apnea(European Respiratory Soc Journals Ltd, 2021) Uysaler, Burcu; Tasbakan, Mehmet Sezai; Pirildar, Sebnem; Basoglu, Ozen K.[No Abstract Available]Öğe Effects of atypical and typical antipsychotic treatments on sexual function in patients with schizophrenia: 12-month results from the Intercontinental Schizophrenia Outpatient Health Outcomes (IC-SOHO) study(Elsevier France-Editions Scientifiques Medicales Elsevier, 2006) Dossenbach, Martin; Dyachkova, Yulia; Pirildar, Sebnem; Anders, Martin; Khalil, Afaf; Araszkiewicz, Aleksander; Shakhnovich, Tamara; Akram, Aly; Pecenak, Jan; McBride, Margaret; Treuer, TamasPurpose. - Sexual dysfunction in patients with schizophrenia can reduce quality of life and treatment compliance. This report will compare the effects of selected atypical and typical antipsychotics on sexual function in a large, international population of outpatients with schizophrenia who were treated over 1 year. Subjects and methods. - Outpatients with schizophrenia, who initiated or changed antipsychotic treatment, and entered this 3-year, prospective, observational study were classified according to the monotherapy prescribed at baseline: olanzapine (N = 2638), risperidone (N = 860), quetiapine (Al = 142) or haloperidol (N = 188). Results. - Based on patient perception, the odds of experiencing sexual dysfunction during I year of therapy was significantly lower for patients treated with olanzapine and quetiapine when compared to patients who received risperidone or haloperidol (all P < 0.001). Females on olanzapine (14%) or quetiapine (8%) experienced a lower rate of menstrual irregularities, compared to females on risperidone (23%) or haloperidol (29%). Significant discordance was evident between patient reports and psychiatrist perception of sexual dysfunction, with psychiatrists underestimating sexual dysfunction (P < 0.001). Conclusion. - These findings indicate clinically relevant differences exist in the sexual side effect profiles of these selected antipsychotics. These factors should be considered when selecting the most appropriate treatment for outpatients with schizophrenia. ((c) 2006 Elsevier SAS. All rights reserved.Öğe Efficacy of Low-dose Pramipexole Augmentation in the Treatment of Refractory Psychotic Depression Complicated with Tardive Dyskinesia: A Case Report(Kure Iletisim Grubu A S, 2011) Erkan, Arzu; Pirildar, Sebnem; Acarer, Ahmet; Akdeniz, FisunEfficacy of low-dose pramipexole augmentation in the treatment of refractory psychotic depression complicated with tardive dyskinesia: a case report Tardive dyskinesia (TD) is a severe complication of antipsychotic treatment. Pramipexole can be effective in the treatment of TD due to its D3 dopamine receptor agonist effect. Studies conducted in bipolar depression and treatment-resistant depression (TRD), support the antidepressant effect of pramipexole. Here we present the case of a 55 year-old female. For the treatment of depression, she received antidepressants, anxiolytics and antipsychotics for 2.5 years. When severe bruxism, fidgeting, and serious functional impairment emerged, she was re-hospitalized and diagnosed with TRD and TD. Several combinations of antidepressants, anxiolytic, and antipsychotics were administered. The depression improved partially, but hypochondriac preoccupations and dyskinesia persisted. At the sixth month, pramipexole 0.125 mg/day was added to sertraline 200 mg/day, amitriptyline 60 mg/day, clonazepam 2 mg/day, and biperiden 4 mg/day. The depression and dyskinesia improved and she was discharged. TRD and TD improved within the first 4 weeks of pramipexole administration and no relapse was observed. Pramipexole is a promising agent in the treatment of TRD and TD.Öğe Evaluation of Heart Rate Variability in Drug Free Panic Disorder Patients(Aves, 2018) Durdu, Gozde Sirin; Kayikcioglu, Meral; Pirildar, Sebnem; Kose, TimurIntroduction: It is well-known that autonomic function is impaired in panic disorder (PD). Heart rate variability (HRV) is a reliable and noninvasive method to evaluate autonomic functions. The aim of this study is to evaluate 24-hour heart rate variability (HRV) parameters in drug-free panic disorder patients. These results are compared with those obtained from healthy controls. Methods: Thirty-two (mean age 33.12 +/- 11.94 years, 20 female, 12 male) drug-free patients for at least 2 weeks, (for fluoksetin 3 weeks) diagnosed with panic disorder (PD) on the basis of DSM-IV criteria were included in the study. The control group comprised of 24 age and gender-matched healthy individuals (mean age 33.45 +/- 8.6 years, 17 female and 7 male) without any cardiac, endocrine (including diabetes), and neurological disease. Two groups were evaluated for any axis-I diagnosis with SCID-I. We used Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Panic Disorder Severity Scale (PDSS) and Anxiety Sensitivity Index-3 (ASI-3) tests in both groups. After the psychiatric evaluation 24 hours Holter ECG monitoring was performed in all participants for the determination of HRV including frequency and time domain parameters. Results: The time domain RMSSD and PNN50 values tended to be lower in panic patients but this difference did not reach significance (p=0.229, p=0.571). There was no significant difference in mean values for all time and frequency domain HRV measures over the total 24-hours recording between patients and controls. RMSSD, pNN50 and HF was increased to reflect the parasympathetic predominance in the sleeping period (p=0.0001) but there was no significant difference between groups. However LF value which showing sympathetic activity was increased significantly in healthy control and patients in the sleeping period (p=0.0001) but there was no significant difference between two groups (p=0.905). Correlation analysis in the panic disorder patients presented a negative correlation between disease age at onset HF value (p=0.004) and positive correlation between LF/HF value (p=0.007). When both smokers and non-smokers were compared in terms of HRV values, smoking significantly decreased HRV in both groups [SDNN (p=0,18)]. Conclusion: HRV parameters of panic disorder patients were not different from healthy controls. To better darify the effects of panic disorder on HRV, factors effecting HRV should be minimized and more Holter ECG studies with longer records should be obtained to reflect the daily life activities.Öğe The impact of hereditary angioedema on quality of life and family planning decisions(Sage Publications Inc, 2019) Tuncel, Ozlem Kuman; Gokmen, Nihal Mete; Demur, Ece; Gulbahar, Okan; Pirildar, SebnemObjective Hereditary angioedema is a serious disease with unpredictable attacks. It has an impact on patients' health-related quality of life. This study aimed to assess the quality of life of the hereditary angioedema patients and to investigate the relationship between quality of life and demographic, clinical, laboratory, and psychiatric parameters. Method A semistructured face-to-face interview, Hamilton depression rating scale, and Hamilton anxiety rating scale were performed by a psychiatrist. Participants completed Medical Outcomes Study Short Form-36, Revised Form of the Multidimensional Scale of Perceived Social Support, Anxiety Sensitivity Index-3, and Adult Separation Anxiety Questionnaire. Patients' complement results were recorded, and clinical data obtained by interview were cross-checked from patients' files. Results In 33 hereditary angioedema patients, subscales of the Study Short Form-36, except for physical functioning, vitality, and mental health were significantly lower compared with population norms. Quality of life scores were found to be correlated with depression, anxiety, anxiety sensitivity, separation anxiety, perceived social support, perceived discrimination, perceived limitation, treatment naive C1-Inhibitor function, and C1q level. Physical role functioning scores were better in the patients using attenuated androgens (p = 0.006, t = -3.027). Hereditary angioedema contributed to the marital problems and childbearing decisions of the patients. Conclusion Hereditary angioedema results in significant impairment in quality of life of the patients and has an impact on family life and life style of the patients. In case of depressive and/or anxiety symptoms, patients should be referred to psychiatrists for better quality of life. Higher levels of C1-inhibitor function and C1q seem to correlate with better quality of life; these needs to be further studied.Öğe Impact of lipodystrophy on health-related quality of life: the QuaLip study(Bmc, 2024) Demir, Tevfik; Simsir, Ilgin Yildirim; Tuncel, Ozlem Kuman; Ozbaran, Burcu; Yildirim, Ilker; Pirildar, Sebnem; Ozen, SamimBackgroundLipodystrophy is a rare disease characterized by loss of adipose tissue. Natural history studies have demonstrated significant burden of disease; however, there is limited data on the impact of lipodystrophy on quality of life (QoL) and psychoemotional well-being. The QuaLip study is a prospective observational real-world study that aims to determine the impact of lipodystrophy on QoL and psychoemotional well-being and explore subjective burden of the disease. Sixty-seven adult patients and eight pediatric patients with lipodystrophy were included. Patients were followed up for 24 months and assessments were repeated every three months. Patients were examined by licensed psychiatrists at baseline, and at year 1 and year 2 visits.ResultsEighteen (27.69%) of 65 adult patients (two subjects refused psychiatric assessment) were diagnosed with a psychiatric disorder (e.g., depressive episodes, mixed anxiety and depressive disorder, anxiety disorder, adjustment disorder, recurrent depression, panic disorder, generalized anxiety disorder, unspecified mood disorder, nonorganic sleep disorder, post-traumatic stress disorder, depressive episode comorbidity, social phobia and obsessive-compulsive disorder comorbidity). Lipodystrophy disease and QoL questionnaires revealed a significant disease burden over the study period. More than one-third of patients reported depression symptoms on the Beck Depression Inventory and more than one-fourth of the patients reported significant hunger throughout the study period. Physical appearance, fatigue, and pain contributed to the disease burden. QoL scores were lower in patients with psychiatric disease and in those with poor metabolic control. Attention deficit hyperactivity disorder, depressive disorder, sub-threshold depressive symptoms, obsessive-compulsive disorder, appetite problems, and issues with physical appearance were identified in selected pediatric subjects.ConclusionsLipodystrophy has a significant impact on QoL and psychoemotional well-being. Psychiatric disorders seem to be underdiagnosed among patients with lipodystrophy.Öğe Mental status and physical activity in patients with homozygous familial hypercholesterolemia: A subgroup analysis of a nationwide survey (A-HIT1 registry)(Elsevier Science Inc, 2020) Tuncel, Ozlem Kuman; Kayikcioglu, Meral; Pirildar, Sebnem; Yilmaz, Mehmet; Kaynar, Leylagul; Aktan, Melih; Tokgozoglu, LaleBACKGROUND: Homozygous familial hypercholesterolemia (HoFH) is a rare, life-threatening disease due to high serum low-density lipoprotein (LDL) cholesterol levels. LDL cholesterol-lowering interventions are fundamental for patients with HoFH. OBJECTIVE: It was aimed to investigate the association between the mental status of patients with HoFH and healthy lifestyle behaviors. METHODS: This subgroup analysis of the A-HIT1 population included the data of patients aged >= 18 years with a clinical diagnosis of HoFH undergoing therapeutic LDL apheresis. Besides the demographic and clinical characteristics of patients, healthy lifestyle behaviors were assessed, and psychiatric symptoms were screened by Symptom Check List (SCL-90-R). RESULTS: the highest percentage for pathology was observed in dimensions of obsessive-compulsive, somatization, interpersonal sensitivity, and depression in SCL-90-R. Patients with any cardiovascular condition have more psychiatric symptoms in different fields of SCL-90-R. the outcomes of the correlative analysis indicated that lower the age of the first coronary event better the psychiatric status, probably denoting a better adaptation to disease and its treatment. Among 68 patients, 36 patients were not exercising regularly. Patients with regular physical activity had significantly lower scores in most dimensions of SCL-90-R and there was no association between regular physical activity and other investigated variables. the strongest predictor of regular exercising was global severity index of SCL-90-R. CONCLUSION: in the HoFH population, there was a high prevalence of mental disturbances. Better psychiatric status was associated with regular exercising. Therefore, assessing the mental status of patients with HoFH and referring patients in need, to a psychiatrist, may improve the outcome of patients. (C) 2020 National Lipid Association. All rights reserved.Öğe Moving from serotonin to serotonin-norepinephrine enhancement with increasing venlafaxine dose: clinical implications and strategies for a successful outcome in major depressive disorder(Taylor & Francis Ltd, 2023) Fagiolini, Andrea; Cardoner, Narcis; Pirildar, Sebnem; Ittsakul, Pichai; Ng, Bernardo; Duailibi, Kalil; El Hindy, NasserIntroductionMental health disorders, especially depressive and anxiety disorders, are associated with substantial health-related burden. While the second-generation antidepressants are widely accepted as first-line pharmacological treatment for major depressive disorder (MDD), patient response to such treatment is variable, with more than half failing to achieve complete remission, and residual symptoms are frequently present.Areas coveredHere, the pharmacodynamics of venlafaxine XR are reviewed in relation to its role as both a selective serotonin reuptake inhibitor (SSRI) and a serotonin-norepinephrine-reuptake inhibitor (SNRI), and we look at how these pharmacodynamic properties can be harnessed to guide clinical practice, asking the question 'is it possible to develop a symptom-cluster-based approach to the treatment of MDD with comorbid anxiety utilizing venlafaxine XR?.' Additionally, three illustrative clinical cases provide practical examples of the utility of venlafaxine-XR in real-world clinical practice. The place of venlafaxine XR in managing fatigue/low energy, a frequent residual symptom in MDD, is explored using pooled data from clinical trials of venlafaxine XR.Expert opinionVenlafaxine XR should be considered as a first-line treatment for MDD with or without comorbid anxiety, and there are clear pharmacodynamic signals supporting a symptom cluster-based treatment paradigm for venlafaxine XR.Öğe Negative impact of COVID-19 pandemic on the lifestyle and management of patients with homozygous familial hypercholesterolemia(Elsevier Science Inc, 2020) Kayikcioglu, Meral; Tokgozoglu, Lale; Tuncel, Ozlem Kuman; Pirildar, Sebnem; Can, Levent[No Abstract Available]Öğe Progesterone Receptor Gene Polymorphism in Panic Disorder: Associations with Agoraphobia and Respiratory Subtype of Panic Disorder(Kure Iletisim Grubu A S, 2010) Pirildar, Sebnem; Bayraktar, Erhan; Berdeli, Afig; Kucuk, Onur; Alkin, Tunc; Kose, TimurObjective: A number of different gene polymorphisms have been found to be involved in the predisposition to development of panic disorder (PD). Previous studies showed that progesterone might play an important role in the psychophysiology of PD. The aim of this study was to investigate the relationship between two different progesterone receptor gene polymorphisms and agoraphobia, nocturnal panic attacks, and respiratory subtype of PD. Methods: Ninety-eight patients diagnosed with PD and 129 healthy controls participated in the study. Patients with PD were divided into two groups on the basis of their symptom profile: respiratory and nonrespiratory subtypes. Seventy-six of 98 patients with PD (79.6%) were in respiratory subtype (RS) of PD. Results: The association between G331A polymorphism and PD in both sexes was significant (p=0.02; OR=2.291; CI=1.141-4.6). PROGINS Alu gene polymorphism was associated with PD in women (p=0.036; OR=0,46; CI=0,219-0.951. It has been also found an assocaition between PROGINS Alu polymorphism and agoraphobia (p=0.002; OR=3.8; CI=1.65-8.76). Conclusion: Our results suggest that the progesterone receptor gene polymorphism might be a susceptibility factor for PD.Öğe Quality of life in obstructive sleep apnea is related to female gender and comorbid insomnia(Springer Heidelberg, 2018) Tasbakan, Mehmet Sezai; Gunduz, Canan; Pirildar, Sebnem; Basoglu, Ozen K.Purpose Obstructive sleep apnea (OSA) is a common sleep disorder affecting health-related quality of life (QoL), and OSA severity is not a reliable indicator for QoL. The aim of this study was (1) to evaluate the impact of gender on QoL and (2) to identify the predictors of QoL in OSA patients. Methods World Health Organization Quality of Life Scale short form (WHOQOL-Bref) was used for evaluating QoL in OSA patients undergoing polysomnography in sleep laboratory of a university hospital. Results Out of 197 patients (age 50.4 +/- 12.1 years, AHI 38.5 +/- 28.4/h), 139 (70.6%) were men and 79.2% had moderate-to-severe OSA. Female gender, increased BMI, higher Epworth sleepiness score (ESS), and lower oxygen saturations were associated significantly with poor QoL in terms of all domains (physical, psychological, social relationship, and environmental) of WHOQOL-Bref questionnaire. The indicators of OSA severity (AHI and ODI) correlated negatively only with the physical domain. The subjects with comorbid insomnia and OSA had lower physical and social scores than subjects with no insomnia, and women with insomnia had significantly worse QoL scores in all domains than the others. In the multivariate linear regression analysis, female gender, comorbid insomnia, increased sleepiness, and higher BMI were significantly associated with poor QoL. Conclusions Female gender, comorbid insomnia, and daytime sleepiness were the outstanding factors affecting health-related QoL negatively in OSA. Besides, the impact of OSA on QoL may be explained by the presence of daytime sleepiness rather than OSA severity.Öğe Testing a Transdiagnostic Model Including Distal and Proximal Risk Factors for Depression and Anxiety(Springer Int Publ Ag, 2023) Gokdag, Ceren; Arkar, Haluk; Pirildar, SebnemThis study aimed to test a transdiagnostic model for depression and anxiety by including childhood trauma and parenting as the distal factors and neuroticism, emotion dysregulation, and repetitive negative thinking (RNT) as the proximal factors. Data were obtained from clinical (major depression, panic, generalized anxiety, or comorbid disorders) and nonclinical samples. Results showed that healthy controls had lower scores than the clinical sample in all measures. Moreover, participants with a single diagnosis had lower scores than those with comorbid diagnoses. The structural regression confirmed that the proximal factor represented by neuroticism, emotion dysregulation, and RNT had a mediating role between the distal factor represented by childhood trauma and negative parenting and emotional symptoms. Results refer to common vulnerability factors underlying depression and anxiety. Such findings indicate the transdiagnostic nature of the variables, provide new insight into psychopathology, and contribute to the development of common psychotherapy programs for emotional disorders.
