Barış Şen

Objective: The aim of this study was to compare burnout, depression, anxiety and broad autism phenotype scores in parents of children diagnosed with autism spectrum disorder (ASD) with parents of typically developing (TD) healthy children and to investigate the relationship between these scores and executive functions. Materials and Methods: This study included 43 parents of children diagnosed with ASD and 53 healthy controls aged 29-40 years. Participants were evaluated with Beck anxiety-depression inventory, Maslach burnout inventory and Autism-Spectrum Quotient (AQ) scores. Parents were assessed with the Structured Clinical Interview for Mental Disorders using the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders and the Stroop test was administered to assess executive functions in parents. Results: Significantly higher anxiety, depression, burnout and AQ scores were observed in the ASD group compared to controls (p< 0.001). Compared to controls, the ASD group performed significantly worse on the Stroop test (p< 0.05). In addition, poor performance in the Stroop test was not significantly associated with anxiety, depression, burnout and AQ scores in the ASD group. Conclusions: This study suggests that parents of children with ASD may have more anxiety, depression and burnout symptoms.

Childhood trauma and dissociative experiences are suggested to be predisposing transdiagnostic factors for attention deficit /hyperactivity disorder (ADHD) as well as many psychiatric disorders. Trauma-related symptoms such as motor restlessness, emotional instability, and concentration problems can mimic, trigger, or exacerbate ADHD symptoms. Moreover, given the relationship between ADHD and trauma-induced distress, it has been suggested that dissociative experiences and attention problems may reveal overlapping characteristics. The aim of this study was to investigate the associations between dissociative experiences and attention deficits by carrying out mixture analysis. A thousand and thirty-seven participants volunteered to the online investigation. Participants completed a test battery that included a sociodemographic form as well as the Adult ADHD Severity Rating Scale (ASRS), Wender Utah Rating Scale (WURS), Childhood Trauma Questionnaire (CTQ), Dissociative Experiences Scale (DES), and Somatoform Dissociation Questionnaire (SDQ). Item responses on the DES and attention deficit symptoms as indexed by the ASRS were subjected to latent class analysis. The three-latent-class model outperformed alternative mixture models. Mixture analysis classified the sample into three homogenous subgroups as follows: (1) No/low dissociation or attention problems; (2) Moderate dissociation with attention problems; and (3) High dissociation with attention problems. High dissociators with attention problems were characterized by heightened scores on somatoform dissociation and emotional neglect. No/low dissociation or attention problems latent class reported significantly lower scores on hyperactivity/impulsivity, depression, attention deficit in childhood, and sexual abuse than both moderate and high dissociation latent classes. High dissociators and moderate dissociators significantly differed on conduct problems and physical abuse. We concluded that impulsive hyperactivity, depression, and childhood sexual abuse were common features in heightened dissociation latent classes, as well as attention deficit.

İlaç etkileşimleri, birlikte kullanılan ilaçların birbirlerinin plazma düzeyini, etkisini veya süresini değiştirmesiyle meydana gelir. Psikotrop ilaçların uzun süreli ve yaygın kullanımı, diğer tıbbi durumlar için kullanılan ilaçlarla etkileşim riskini ve hastaneye yatış oranlarını artırmaktadır. Bu etkileşimler farmasötik, farmakokinetik veya farmakodinamik olarak sınıflandırılır. Farmakokinetik etkileşimler; emilim, dağılım, metabolizma ve atılım aşamalarında gerçekleşerek ilacın vücuttaki konsantrasyonunu değiştirir. Besinler, mide pH'ı ve P-glikoproteinler emilimi etkilerken; plazma proteinlerine bağlanma oranları dağılım düzeyindeki etkileşimleri belirler. Özellikle dar terapötik aralığa sahip lityum gibi ilaçlarda atılım düzeyindeki etkileşimler kritiktir. Karaciğerdeki CYP450 mikrozomal enzimleri ise ilaç metabolizmasından sorumludur; bu enzimlerin inhibisyonu veya indüksiyonu diğer ilaçların etkisini doğrudan değiştirir. Farmakodinamik etkileşimler ise reseptör düzeyinde konsantrasyonu etkilemeden agonistik, sinerjik, potansiyasyon veya antagonistik şekilde gerçekleşir ve serotonin sendromu, aritmi gibi ciddi klinik bulgulara yol açabilir. Sonuç olarak, giderek artan ilaç etkileşim bilgilerinin yönetiminde bilgisayar tabanlı veri tabanları ve akılcı ilaç seçimi büyük önem taşımaktadır. Drug interactions occur when concomitantly used medications alter each other's plasma levels, efficacy, or duration. The prolonged and widespread use of psychotropic drugs escalates the risk of interaction with medications prescribed for other medical conditions, thereby increasing hospitalization rates. These interactions are categorized as pharmaceutical, pharmacokinetic, or pharmacodynamic. Pharmacokinetic interactions take place during the phases of absorption, distribution, metabolism, and excretion, altering the drug's concentration in the body. Food, gastric pH, and P-glycoproteins affect absorption, whereas plasma protein binding rates determine interactions at the distribution level. Interactions at the excretion level are critical, especially for drugs with a narrow therapeutic index, such as lithium. Microsomal CYP450 enzymes in the liver are responsible for drug metabolism; the inhibition or induction of these enzymes directly modifies the effects of other drugs. Pharmacodynamic interactions, on the other hand, occur at the receptor level without altering concentration—manifesting as agonistic, synergistic, potentiation, or antagonistic effects—and can lead to severe clinical manifestations such as serotonin syndrome or arrhythmia. Consequently, computer-based databases and rational drug selection hold paramount importance in managing the continuously increasing body of drug interaction knowledge.

The aim of this study was to investigate the relationships among childhood trauma, dissociative experiences, and internet gaming disorder (IGD) in young adults diagnosed with attention deficit hyperactivity disorder (ADHD) and age- and gender-matched controls. Forty participants diagnosed with ADHD at a university hospital psychiatric outpatient clinic and 40 healthy controls completed a test battery that included a sociodemographic form as well as the Adult ADHD Severity Rating Scale (ASRS), Childhood Trauma Questionnaire (CTQ), Dissociative Experiences Scale (DES), Somatoform Dissociation Questionnaire (SDQ), and Internet Gaming Disorder Scale – Short Form (IGDS9-SF). The CTQ (t = −4.61, p < .01), DES (t = −4.71, p < .01), SDQ (t = −2.40, p < .01), and IGDS9-SF (t = −4.89, p < .01) scores were significantly higher in the ADHD group than in the control group. A hierarchical regression analysis that explained 50% of unique variance in internet gaming disorder (IGD) indicated that being male (β = 0.41, t = 4.61, p < .001) and having an ADHD diagnosis (β = 0.48, t = 5.49, p < .001) are robust predictors. Additionally, the DES score, which indicates the severity of psychoform dissociation (β = 0.34, t = 2.43, p = .017), was found to be significantly associated with IGD after controlling for ADHD diagnosis and childhood trauma. While excessive gaming may increase dissociative symptoms, the mental state of dissociative experiences may be a predisposing factor for IGD; however, further studies are needed to investigate these claims.

Lityum, 1800’lü yılların başında İ̇sveçli Arfvedson tarafından keşfedilmiş ve 1950’li yıllarda psikiyatri alanında kullanılmaya başlanmıştır. Yetişkinlerde bipolar tedavisinde ilk sırada gelen bir duygudurum düzenleyici ve altın standart bir tedavi ajanıdır. Ancak, klinik uygulamada bireyler arasında lityum tedavisine yanıt oranları hastaların farklı özellikleri nedeniyle oldukça değişken olup, hangi hastanın lityuma iyi yanıt vereceğini öngörmek çoğunlukla zordur. Lityum tedavi yanıtını öngörmede klinisyenler öncelikle klinik bir fenotipi tanımaya odaklanmış gibi durmaktadır. Bu yazıda lityum tedavi yanıtının yordayıcıları ile ilgili araştırmalar gözden geçirilerek; klinik, biyokimyasal, nörogörüntüleme ve genetik yordayıcılar olmak üzere dört başlık altında ele alınmıştır.