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Öğe Development, reliability and validity of bipolar disorder functioning questionnaire(Blackwell Publishing, 2006) Aydemir, Omer; Eren, Ibrahim; Savas, Haluk; Kalkan-Oguzhanoglu, Nalan; Kocal, Nesrin; Devrimci-Ozguven, Halise; Akkaya, Cengiz; Devrim-Basterzi, Ayse; Karlidag, Rifat; Yenilmez, Cinar; Ozerdem, Aysegul; Kora, Kaan; Tamam, Lut; Gulseren, Seref; Oral, Timucin; Vahip, SimaviÖğe The effect of previous psychotic mood episodes on cognitive impairment in euthymic bipolar patients(Blackwell Publishing, 2007) Bora, Emre; Vahip, Simavi; Akdeniz, Fisun; Gonul, Ali Saffet; Eryavuz, Ayse; Ogut, Melise; Alkan, MugeObjectives: Cognitive dysfunctions in several domains were proposed to be trait markers of bipolar patients. The aim of this study was to evaluate the effect of previous psychotic features on neuropsychological measures, including sustained attention, in remitted bipolar patients. Methods: The study participants were 40 euthymic psychotic, 25 non-psychotic bipolar I patients and 30 healthy control subjects. Participants were assessed with a battery of neuropsychological tests targeting attention, executive functions, psychomotor speed, verbal learning and memory. Results: Euthymic psychotic bipolar patients performed worse than controls on most of the measures, after controlling for the confounding effects of education, age and residual symptoms. Non-psychotic patients were also impaired on tasks of attention, fluency and psychomotor speed. 'Number of Wisconsin Card Sorting Test (WCST) categories' achieved was the only measure on which psychotic patients performed significantly worse compared to non-psychotic patients. Differences among patient groups were not explained by illness severity measures. The duration of illness was related to slowness in psychomotor speed tasks. Verbal memory deficits may be related to serum lithium levels and age of onset of disease. Conclusions: Deficits in cognitive flexibility may be a candidate for being a trait marker of psychotic features among bipolar patients. However, verbal fluency, psychomotor speed and sustained attention deficits may be candidates for vulnerability indicators of bipolar disorder in general.Öğe Executive and verbal working memory dysfunction in first-degree relatives of patients with bipolar disorder(Elsevier Ireland Ltd, 2008) Bora, Emre; Vahip, Simavi; Akdeniz, Fisun; Ilerisoy, Hatice; Aldemir, Ebru; Alkan, MuegeThe authors aimed to investigate cognitive performance of first-degree relatives of probands with bipolar disorder (BD). They hypothesized that the relatives of BD patients would have impaired performance on cognitive tests of frontal-executive functions. A neuropsychological battery was administered to 34 first-degree relatives of BD probands and 25 control subjects. Relatives showed significant impairment in verbal working memory and executive function. Verbal memory and psychomotor performances of relatives were not different from control subjects. One particular component of executive function, cognitive flexibility, was associated with family history of mood episodes with psychotic features. Verbal working memory and executive function deficits may be useful endophenotypic markers of genetic vulnerability to BD. (C) 2007 Elsevier Ireland Ltd. All rights reserved.Öğe Executive dysfunction and cognitive subgroups in a large sample of euthymic patients with bipolar disorder(Elsevier Science Bv, 2016) Bora, Emre; Hidiroglu, Ceren; Ozerdem, Aysegul; Kacar, Omer Faruk; Sarisoy, Gokhan; Arslan, Filiz Civil; Aydemir, Omer; Tas, Zeynep Cubukcuoglu; Vahip, Simavi; Atalay, Adnan; Atasoy, Nuray; Atesci, Figen; Tumkaya, SelimBipolar disorder (BP), at the group level, is associated with significant but modest cognitive deficits, including executive dysfunction. Among executive functions, response inhibition deficits have been suggested to be particularly relevant to BR However, BP is associated with significant heterogeneity in neurocognitive performance and level of functioning. Very few studies have investigated neurocognitive subgroups in BP with data-driven methods rather than arbitrarily defined criteria. Other than having relatively small sample sizes, previous studies have not taken into consideration the neurocognitive variability in healthy subjects. Five hundred-fifty-six euthymic patients with BP and 416 healthy controls were assessed using a battery of cognitive tests and clinical measures. Neurocognitive subgroups were investigated using latent class analysis, based on executive functions. Four neurocognitive subgroups, including a good performance cluster, two moderately low-performance groups, which differ in response inhibition and reasoning abilities, and a severe impairment cluster were found. In comparison to healthy controls, BP patients were overrepresented in severe impairment cluster (27% vs 5.3%) and underrepresented in good performance cluster. BP patients with lower educational attainment and older age were significantly more likely to be members of cognitively impaired subgroups. Antipsychotic use was less common in good performance cluster. These results suggest that there is a considerable overlap of cognitive functions between BP and healthy controls. Neurocognitive differences between BP and healthy controls are driven by a subgroup of patients who have severe and global, rather than selective, cognitive deficits. (C) 2016 Elsevier B.V. and ECNP. All rights reserved.Öğe İleri Yaştaki Bipolar Bozukluk Hastalarının Gereksinimlerinin Belirlenmesi(2021) Vahip, Simavi; Zihni, Figen Yargucu; Tunçel, Özlem Kuman[Abstract Not Available]Öğe Lityum kullanım süresinmin renal tübüler işlevlere etkisi(Ege Üniversitesi, 1994) Vahip, Simavi1-15 yıldan beri lityum kullanmakta olan bipolar bozukluk tanılı 108 hasta ve eşleştirilmiş 29 psikiyatrik kontrol hastasının ?2-mg (beta-2-mikroglobulin) ve GAG'ın (glikozaminoglikan) idrarla atılımları karşılaştırılmıştır. Lityum grubunda 24 saatlik idrar volümü, idrar ?2-mg ve GAG değerleri kontrol grubuna kıyasla anlamlı olarak yüksek, maksimal üriner osmolalite ise düşük bulunmuştur. Kreatinin klirensi ile hastalık süresi, lityum kullanım süresi konsantrasyon kapasitesi ile de ilişkili bulunmamıştır. ?2-mg atılım hızı, belirgin poliürisi olan ve ağır konsantrasyon defekti bulunan hastalarda anlamlı olarak daha yüksek bulunmuştur.Öğe Manic switch in hospitalized bipolar depressive patients: 5 year data(Blackwell Publishing, 2006) Vahip, Simavi; Isman, Damla; Aldemir, Ebru; Ozden, Mustafa; Daglioz, Gokce; Akdeniz, Fisun; Gonul, Ali SaetÖğe Mental health services during the first wave of the COVID-19 pandemic in Europe: Results from the EPA Ambassadors Survey and implications for clinical practice(Cambridge Univ Press, 2021) Rojnic Kuzman, Martina; Vahip, Simavi; Fiorillo, Andrea; Beezhold, Julian; Pinto da Costa, Mariana; Skugarevsky, Oleg; Dom, GeertBackground The COVID-19 pandemic caused an unprecedented worldwide crisis affecting several sectors, including health, social care, economy and society at large. The World Health Organisation has emphasized that mental health care should be considered as one of the core sectors within the overall COVID-19 health response. By March 2020, recommendations for the organization of mental health services across Europe have been developed by several national and international mental health professional associations. Methods The European Psychiatric Association (EPA) surveyed a large European sample of psychiatrists, namely the EPA Ambassadors, on their clinical experience of the impact of COVID-19 pandemic on the treatment of psychiatric patients during the month of April 2020 in order to: a) identify and report the views and experiences of European psychiatrists; and b) represent and share these results with mental health policy makers at European level. Based on the recommendations issued by national psychiatric associations and on the results of our survey, we identified important organisational aspects of mental health care during the peak of the first wave of the COVID-19. Results While most of the recommendations followed the same principles, significant differences between countries emerged in service delivery, mainly relating to referrals to outpatients and for inpatient admission, assessments and treatment for people with mental disorders. Compared to previous months, the mean number of patients treated by psychiatrists in outpatient settings halved in April 2020. In the same period, the number of mentally ill patients tested for, or developing, COVID-19 was low. In most of countries, traditional face-to-face visits were replaced by online remote consultations. Conclusions Based on our findings we recommend: 1) to implement professional guidelines into practice and harmonize psychiatric clinical practice across Europe; 2) to monitor the treatment outcomes of patients with COVID-19 and pre-existing mental disorders; 3) to keep psychiatric services active by using all available options (for example telepsychiatry); 4) to increase communication and cooperation between different health care providers.Öğe Obesity among patients with mood disorders(Blackwell Publishing, 2006) Akdeniz, Fisun; Bilen, Nesli K.; Zorlu, Nabi; Arik, Deniz; Vahip, Simavi; Cam, Aysegul; Gonul, Ali S.Öğe Opening new horizons in the field of bipolar disorder: The power of observation, research, thinking and creation(Klinik Psikiyatri Dergisi, 2021) Vahip, Simavi[No Abstract Available]Öğe Opening up new horizons in the field of bipolar disorders: power of observation, research, thinking and creativity(Klinik Psikiyatri Dergisi, 2021) Vahip, Simavi[No Abstract Available]Öğe Profilaktik amaçla lityum kullanmakta olan remisyondaki bir grup bipolar bozukluk tanılı hastada eritrosit içi lityum konsantrasyonu ve lityum oranının etkinlik ve yan etkilerle ilişkisinin araştırılması(Ege Üniversitesi, 1986) Vahip, SimaviÖZET Bu çalışmada profilaktik amaçla lityum kullanmakta olan "Bipolar Bozukluk, Remisyonda" tanılı 64 hastada ei'itrofcit içi lityum konsantrasyonuyla lityum oranının bazı durumlar için gösterge olabilirliği araştırılmıştır. Tüm hastaların katıldığı bölümde, prfilaktik lityum kullanımı sırasında görüldüğünü saptadığımız yan etkiler için eritrosit lityum konsantrasyonunu ve lityum oranının ne denli gösterge olabileceği belirlenmeye çalışılmıştır. 33 uygun hastanın katıldığı bölümde ise profilaksiden belirgin yararlananlar, orta dereceden yararlananlar ve yararlanmayanların lityum oranları yönünden farklılık gösterip göstermedikleri araştırılmıştır. Bunların yanında araştırılan hastalık süresi, lityum kullanım süresi, yaş, cinsiyet, affektif hastalık yönünden ailesel yüklülük gibi bazı ek değişkenler de gözönüne alınarak elde edilen bulgular literatür ışığında tartışılmıştırÖğe Reliability and validity of Turkish version of Biological Rhythms Interview of Assessment in Neuropsychiatry(Cumhuriyet Univ Tip Fak Psikiyatri Anabilim Dali, 2012) Aydemir, Omer; Akkaya, Cengiz; Altinbas, Kursat; Kora, Kaan; Suculluoglu Dikici, Didem; Akdeniz, Fatma; Kalayci, Fatma; Oral, E. Timucin; Vahip, SimaviObjective: In this study, it is aimed to perform the validity and reliability of the Turkish version of Biological Rhythms Interview of Assessment in Neuropsychiatry. Methods: The study was performed with 79 bipolar type-I disorder, 26 bipolar type-II disorder and 42 major depressive disorder patients attending to mood disorder clinics of three university hospitals and one state training hospital as well as 116 university students consisting healthy control subjects. The mean duration of the illness was 15.1 years for the bipolar groups and 9,3 years for the depressive group. For concurrent validity, Pittsburgh Sleep Quality Index was used. In the statistical analyzes, internal consistency coefficient, item-total score correlations, exploratory and confirmatory factor analyzes, correlation with the other scale and ROC curve were calculated. Results: The forward and back translation of the Biological Rhythms Interview of Assessment in Neuropsychiatry was performed, and linguistic equivalence was obtained with the scale prepared. In internal consistency, the Cronbach's alpha coefficient was found to be 0.899 and item-total correlation coefficients were between 0.239 and 0.747. In the exploratory factor analysis, a total of three factors representing 56.5% of the total variance were obtained and the themes of the factors were daily activities, sleep and eating habits and interpersonal relations. In the confirmatory factor analysis, confirmatory fit index was 0.932 and root mean square of approximation was 0.065. The correlation between Biological Rhythms Interview of Assessment in Neuropsychiatry and Pittsburgh Sleep Quality Index was found to be r=0.238. In the sensitivity and specificity analysis, the area under the ROC curve was 0.876. The scale discriminated mood disorder groups from the healthy control group. Conclusion: It is shown that the Turkish version of Biological Rhythms Interview of Assessment in Neuropsychiatry which is used in the assessment of circadian rhythm and functionality is reliable and valid.Öğe Reliability and Validity Study of the Turkish Version of Hypomania Checklist-32-Revised(Turkiye Sinir Ve Ruh Sagligi Dernegi, 2017) Vahip, Simavi; Aydemir, Omer; Akkaya, Cengiz; Altinbas, Kursat; Kora, Kaan; Suculluoglu Dikici, Didem; Akdeniz, Fatma; Kalayci, Fatma; Oral, Timucin; Vahip, Isil; Alkan, Muge; Angst, JulesObjective: In this study, it is aimed to evaluate the reliability and validity of the Turkish version of Hypomania Checklist-32-Revised. Method: The study was carried out with 80 patients diagnosed with bipolar I disorder, 26 patients diagnosed with bipolar II disorder and 42 patients diagnosed with major depressive disorder attending the out- and in-patient psychiatry departments of three university hospitals and one training hospital, and 116 healthy volunteers consisting of university students. Mean duration of illness was 15,1 years for the bipolar disorder group, and 9,3 years for the major depressive disorder group. For concurrent validity, Mood Disorder Questionnaire was used. In the statistical analysis, internal consistency coefficient, item-total score correlation coefficients, exploratory factor analysis, correlation with concurrent scale and ROC curve were calculated. Results: Translation into Turkish and back-translation into English of Hypomania Checklist-32-Revised were performed and thus the semantic harmony of the scale was obtained. In the internal consistency, Cronbach alpha coefficient was 0,914 and item-total score correlations were between 0,235-0.743. Solely the coefficient of item #23 was found as 0,110. In factor analysis, six factors were obtained but a two-factor solution representing 44,5% of the total variance was accepted and first factor represents overactivity and being expansive, second factor represents impulsivity and risky behaviors. Correlation of Hypomania Checklist-32-R with Mood Disorder Questionnaire was r=0,379. In the ROC analysis, the cut off point of the scale was calculated as 14 with a sensitivity of 71,0 and specificity of 69,8. The scale discriminates well between the bipolar group, and depressive and control groups. Conclusion: Hypomania Checklist-32-Revised developed for screening hypomania is reported to be reliable and valid in Turkish after cutting out item #23.Öğe Reproductive and Sexual Functions in Bipolar Patients: Data from a Specialized Mood Disorder Clinic(Yerkure Tanitim & Yayincilik Hizmetleri A S, 2016) Aldemir, Ebru; Akdeniz, Fisun; Isikli, Serhan; Bilen, Nesli Keskinoz; Vahip, SimaviObjective: The objective of this study is to investigate the reproductive characteristics and sexual functions in bipolar patients monitored in a specialized mood disorder clinic, identify their potential relationship with the use of psychotropics, and investigate gender differences. Method: The study included 193 patients (100 men, 93 women) with a DSM-IV diagnosis of bipolar disorder being followed at Ege University Affective Disorders Outpatient Unit. Reproductive characteristics of the patients were examined at the evaluation. Sexual dysfunctions were evaluated using the International Index of Erectile Function in men and Arizona Sexual Experience Scale in women. Results: There was no significant difference between men and women regarding age, duration of marriage, duration of illness, duration of mood stabilizer and antipsychotic drugs use and dosage of antipsychotic drugs. Age at pubarche in men was 13.8 +/- 1.2 years, age at menarche in women was 13.2 +/- 1.3 years. Current menstrual cycle irregularities were found in 15.1% (n=14) of women. Prevalence of lifetime menstrual irregularities was 38.7% (n=36). 60.4% (n=67) of patients having an active sexual life were using an effective contraception method. 31.7% (n=26) of female patients had sexual dysfunction whilst 52% (n=39) of male patients had erectile dysfunction. In both men and women, no significant difference was found between groups using mood stabilizers and antipsychotic drugs in terms of sexual dysfunction. There was no correlation between sexual function scores and usage and duration of mood stabilizers and antipsychotic drugs in either sex. Conclusions: This cross-sectional study with a relatively large bipolar sample group concluded that the patients' reproductive and sexual functions were not as much affected by bipolar disorder and psychotropic drug use as had been assumed. However, these results should be supported with prospective and controlled trials.Öğe Reproductive and Sexual Functions in Bipolar Patients: Data from a Specialized Mood Disorder Clinic(2016) Aldemir, Ebru; Akdeniz, Fisun; Işıklı, Serhan; Bilen, Nesli Keskinoz; Vahip, SimaviBipolar bozukluk tanılı hastalarda üreme ve cinsel işlevler: Uzmanlaşmış bir duygudurum bozuklukları kliniği verileri. Amaç: Bu çalışmanın amacı, bir duygudurum bozuklukları kliniğinde izlenmekte olan bipolar hastalarda üreme özellikleri ve cinsel işlevleri araştırmak, psikotrop kullanımı ile olası ilişkiyi belirlemek ve cinsiyetler arası farkları incelemektir.Yöntem: Ege Üniversitesi Affektif Hastalıklar Birimi'nde izlenen DSM-IV'e göre bipolar bozukluk tanılı toplam 193 hasta (100 erkek, 93 kadın) çalışmaya dahil edildi. Yapılan değerlendirmede hastaların üreme özellikleri sorgulandı. Cinsel işlevler, erkeklerde Ereksiyon İşlevi Uluslararası Değerlendirme Formu, kadınlarda Arizona Cinsel Yaşantılar Ölçeği kullanılarak değerlendirildi.Bulgular: Kadın ve erkek hastalar arasında yaş, evlilik süresi, hastalık süresi, duygudurum dengeleyici (DD) ve antipsikotik (AP) ilaç kullanımı süresi ve AP kullanım dozu açısından anlamlı fark yoktu. Erkeklerde pubarş yaşı 13.8±1.2, kadınlarda menarş yaşı 13.2±1.3'tü. Halihazırda adet düzensizliği kadınların %15.1'inde (n=14) mevcuttu. Yaşam boyu adet düzensizliği yaygınlığı %38.7 (n=36) idi. Aktif cinsel yaşantısı olan hastaların %60.4'ü (n=67) etkin bir doğum kontrol yöntemi kullanıyordu. Kadın hastaların %31.7'sinde (n=26) cinsel işlev bozukluğu, erkek hastaların %52'sinde (n=39) erektil işlev bozukluğu saptandı. Her iki cinsiyette cinsel işlev bozukluğu açısından DD ve AP kullanımı olan gruplar arasında anlamlı farklılaşma saptanmadı.Sonuç: Kesitsel desendeki bu çalışmada, göreli büyük bir bipolar örneklem grubunda, hastaların üreme ve cinsel işlevler açısından, hastalık ve ilaç tedavisinden sanıldığı kadar yaygın etkilenmediği sonucuna ulaşılmıştır. Ancak ileriye dönük ve kontrollü çalışmalarla bu bulguların desteklenmesi gerekmektedir.Öğe Sustained attention deficits in manic and euthymic patients with bipolar disorder(Pergamon-Elsevier Science Ltd, 2006) Bora, Emre; Vahip, Simavi; Akdeniz, FisunSustained attention deficits are proposed to be both state and trait indicators of bipolar disorder. The nature of these deficits and their association with medication and symptoms is not clear yet. The aim of this study was to investigate the impairments in various components of sustained attention task in euthymic and manic patients and was to investigate the relationship between the deficits in the manic state and medication effects. The performances of 37 manic patients, 34 euthymic patients with bipolar disorder and 34 control subjects on eight scores from Conners' CPT II, reflecting three different dimensions of sustained attention were compared. Similar to some recent findings, euthymic patients had decreased target sensitivity (omission errors) and response time inconsistency. The increased false responding (commission errors), perseveration and vigilance deficits were prominent in the manic patients. These state dependent impairments could not be explained by the impact of medication. In contrast, the exacerbation of seemingly trait-related impairments in the manic state can be at least partly explained by the impact of pharmacological therapy. (c) 2006 Elsevier Inc. All rights reserved.Öğe Theory of mind and executive functions in schizophrenia and bipolar disorder: A cross-diagnostic latent class analysis for identification of neuropsychological subtypes(Elsevier Science Bv, 2016) Bora, Emre; Veznedaroglu, Baybars; Vahip, SimaviObjective: Executive dysfunction is a common feature of schizophrenia and bipolar disorder (BP). While deficits in social cognitive abilities, including theory of mind (ToM), have been suggested to be specific to schizophrenia, available evidence suggests that there is also a significant overlap in social cognitive performances of both disorders. However, there is significant heterogeneity of executive dysfunction and ToM deficits in BP and schizophrenia. Cross-diagnostic data-driven methods can reveal potential neurocognitive subtypes characterized by relatively selective deficits in social cognition. Methods: Neurocognitive subgroups were investigated using latent class analysis, based on executive functions and ToM, in a mixed sample of 97 clinically stable patients with schizophrenia or BP and 27 healthy controls. Results: Four neurocognitive subgroups, including a "neuropsychologically normal" cluster, a severe global impairment cluster and two clusters of mixed cognitive profiles were found. Severe impairment cluster was characterized by particularly severe ToM deficits and predominantly included patients with schizophrenia. Schizophrenia patients in this cluster had severe negative symptoms. In contrast, individuals with BP compared to schizophrenia patients were more likely to be included in the "neuropsychologically normal" cluster. Conclusion: Identification of distinctive neurobiological subtypes of patients based on social and non-social cognitive profiles can improve classification of major psychoses. Neurocognitive subgroupings of patients might be also beneficial for intervention strategies including cognitive rehabilitation. (C) 2016 Elsevier B.V. All rights reserved.Öğe Valproate-Associated Reproductive Hormone Abnormalities: Do Bipolar Men have the Same Risk as Epileptic Men?(Turkiye Sinir Ve Ruh Sagligi Dernegi, 2012) Aldemir, Ebru; Akdeniz, Fisun; Altay, Ahmet Baris; Arici, Sehnaz; Umul, Mehmet; Aydin, Hikmet Hakan; Celebisoy, Mehmet; Vahip, SimaviValproate-Associated Reproductive Hormone Abnormalities: Do Bipolar Men have the Same Risk as Epileptic Men? Objective: The effects of valproate on male reproductive hormones have been studied in epileptic patients and animals, but the results are inconsistent because reproductive hormone abnormalities may be independent of the use of valproate and may be due to epilepsy itself. The aim of this study was to determine if there is an association between valproate and reproductive abnormalities in men with bipolar disorder or if the association is unique to men with epilepsy. Materials and Method: The study included 39 male patients aged 18-50 years with a DSM-IV diagnosis of bipolar disorder (21 on lithium monotherapy and 18 on valproate monotherapy or valproate in combination with lithium therapy) and 15 male epilepsy patients on valproate monotherapy that were evaluated in terms of reproductive hormones. Results: Duration of illness, duration of lithium and valproate therapy, daily dose and serum concentrations of lithium and valproate, duration of marriage, spouse's gravidity, the serum estradiol, luteinizing hormone, sex hormone-binding globulin, and free testosterone levels, and the free testosterone:luteinizing hormone ratio were not significantly different between the groups. Serum prolactin and follicle-stimulating hormone levels were significantly higher in the epilepsy patients than in the bipolar disorder patients on lithium monotherapy. Conclusion: The findings show that valproate did not have a negative effect on male reproductive hormones in the bipolar patients. The elevated prolactin and follicle-stimulating hormone levels observed in the epilepsy group should be attributed to epilepsy. To the best of our knowledge this is the first study to compare reproductive hormones in bipolar disorder and epilepsy patients on valproate therapy.