Browsing by Author "Kotan, Vahap Ozan"
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Item Differences in sociodemographic characteristics, clinical features and serum liver function tests of male cannabis and synthetic cannabinoid users(Cumhuriyet Üniversitesi, 2017-08-01) Kotan, Vahap Ozan; Yücens, Bengi Baz; Kotan, Zeynep; Okay, İhsan Tuncer; Tikir, Baise; Göka, Erol; Özkaya, Güven; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0003-0297-846X; A-4421-2016; 16316866500Objective: Synthetic cannabinoid (SC) use has recently become a growing substance abuse problem, with serious harmful clinical effects. Young males, especially cannabis (C) users, are at great risk of SC use. The aim of this study is to determine sociodemographic characteristics, clinical features and serum liver function tests of SC users and compare with those of C users. Methods: Out of 118 SC users applied to outpatient clinic of Ankara Numune Training and Research Hospital Alcohol and Substance Addiction Treatment Center, 74 males included in this cross-sectional study. Patients with a concurrent use of any medication or substance other than C/SCs or patients with any physical illness which could affect serum liver function tests were excluded. 44.6% (n=33) of 74 patients were only SC users at least for last three months and 55.4% (n=41) were combined C and SC (C&SC) users. SC users were compared with 34 age and BMI-matched only C using males. Results: Rates of being single and divorced; rates of living with friends and alone were found to be higher in SC users. Adverse effects and withdrawal sypmtoms were found to be similar in C users and SC users. According to serum liver function test results, levels of gama-glutamil transpeptidase, alkaline phosphatase, total/direct bilirubin, albumin, prothrombin time and international normalized ratio were similar. Serum aspartate aminotransferase levels (31.2±22.0 IU/L and 41.5±21.5 IU/L respectively, p=0.026) and serum alanine aminotransferase levels (28.4±18.9 IU/L and 44.3±25.9 IU/L respectively, p=0.015) differed between C users and C&SC users. Results in this study revealed that increased serum levels of aminotransferases were especially associated with combined use of C and SCs. Conclusions: C abuse seems to be a precursor of SCs abuse, and risk of starting SCs use could be bigger for C users, who live alone or with friends, whereas living together with a family could be preventative. Combined use of C and SCs seem to increase the risk of hepatocellular injury compared to either C or SCs alone.Item The effectiveness of risperidone long-acting injection in oral antipsychotic non-adherent patients with schizophrenia: A retrospective study(Küre İletişim Grubu A.Ş, 2009-09) Akkaya, Cengiz; Sarandöl, Aslı; Kotan, Vahap Ozan; Cangür, Şengül; Aydın, Ayşegül; Kirli, Selçuk; Uludağ Üniversitesi/Tıp Fakültesi/Psikiyatri Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 14061855100; 14020405100; 35096351000; 8604063700; 15059926700; 14019745700Objective: To determine effectiveness and adherence to risperidone long-acting injection (RLAI) in schizophrenic patients who were non-adherent to oral antipsychotic treatment. Method: We retrospectively checked over 30 schizophrenic patients (12 males, mean age=36.1 +/- 9.5 years) who were hospitalized for relapse of their disorder due to non-adherence to oral antipsychotic drugs. Assessment tools were Brief Psychiatric Rating Scale (BPRS), Scale for Assessment of Positive Symptoms (SAPS), Scale for Assessment of Negative Symptoms (SANS) and Simpson-Angus Scale (SAS). Mean follow-up was 236.1 +/- 121.0 (28-336) days. For 11 patients (36.7%), oral add-on antipsychotic treatment (OAT) was discontinued after the 3rd injection of risperidone (No-OAT group); for 19 (63.3%), it was continued (OAT group). Results: The proportion who discontinued medications was 46.7% overall; it was 45.5% for OAT and 47.4% for No-OAT groups (P=0.781). Mean BPRS, SAPS, SANS, and SAS scores decreased significantly from baseline during follow-up. The No-OAT group had a greater decrease (percent change in BPRS from baseline) than the OAT group at the 3(rd), 6(th), 9(th), 10(th), 11(th), 12(th), 13(th), 15(th) and 17(th) visits; for SANS, it was greater at the 6(th) and 10th visits (P<0.05 for both). The mean dose of RLAI was 46.9 +/- 6.7 mg, and this was similar for OAT and No-OAT groups (49 +/- 9.8 and 44 +/- 9.8, respectively, P = 0.292). Conclusions: In daily clinical practice, long-acting injectable risperidone is effective in schizophrenic patients, but oral antipsychotic drugs are frequently needed to be used together with RLAI in severe and chronic cases. RLAI had no additional effectiveness or adherence advantage in this study for patients with severe forms of schizophrenia.Item Effects of long-term antidepressant treatment on oxidative status in major depressive disorder: A 24-week follow-up study(Pergamon-Elsevier Science, 2011-07-19) Kotan, Vahap Ozan; Kırhan, Emine; Özkaya, Güven; Kirli, Selçuk; Sarandöl, Emre; Uludağ Üniversitesi/ Tıp Fakültesi/Biyokimya Anabilim Dalı.; Uludağ Üniversitesi/ Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; Uludağ Üniversitesi/ Tıp Fakültesi/Psikiyatri Anabilim Dalı.; 0000-0002-2593-7196; 0000-0003-0297-846X; ABE-1716-2020; A-4421-2016; 37104411100; 16316866500; 14019745700; 55943324800Purpose: Major depressive disorder (MDD) is a devastating disease that afflicts large populations and has also been accepted to be an independent risk factor for cardiovascular disease (CVD). Oxidative stress seems to play an essential role in the relationship of MOD and CVD. We aimed to determine the level of oxidative stress in patients with MOD and to investigate the effects of long-term antidepressant (AD) treatment on the oxidative-antioxidative system parameters and CVD risk factors. Method: Fifty patients who fully met the fourth Diagnostic and Statistical Manual of Mental Disorders criteria for MOD and 44 healthy control subjects were included in the study. Control visits of the patients were repeated 6 weeks, 12 weeks and 24 weeks after beginning of the AD treatment Lipid profiles, oxidation and oxidizability of apolipoprotein B-containing lipoproteins (expressed as apo B-b-MDA and apo B-Delta-MDA, respectively), levels of plasma malondialdehyde (p-MDA), total antioxidative capacity (TAOC), antioxidant molecules and antioxidant enzyme activities including paraoxonase/arylesterase, red blood cell superoxide dismutase (RBC-SOD) and glutathione peroxidase were determined during 24-week of follow-up period. Results: According to the results of the study, p-MDA, apo B-b-MDA and RBC-SOD activity were increased and arylesterase activity was decreased in MDD patients. Body mass index (BMI), vitamin A and total cholesterol levels in MDD patients increased after 24-weeks of AD treatment RBC-SOD activity, TAOC, p-MDA and apo B-b-MDA levels were decreased: paraoxonase/arylesterase activities and apo B-Delta-MDA were increased at the end of 24th week. Conclusion: Oxidative stress, demonstrated in MDD patients, was partly improved during 24 weeks of AD treatment Increase in paraoxonase/arylesterase activities and decrease in p-MDA and apo B-b-MDA levels after 24 weeks seem to be beneficial for reduction of CVD risk in MDD patients. However increased BMI and apo B-Delta-MDA levels are negative cardiovascular effects of long-term AD treatment.Publication Evaluation of dsyfunctional attitudes, distress and discomfort tolerance levels in patients with premenstrual dysphoric disorder(Klinik Psikiyatri Dergisi, 2020-01-01) Erzin, Gamze; Kılınçel, Oğuzhan; Bayram, Şenol; Kılıç, Osman Hasan Tahsin; Kotan, Vahap Ozan; Göka, Erol; Özdel, Kadir; Özkaya, Güven; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; JJW-0446-2023Objective: In this research article, we investigated the possible effects of premenstrual dysphoric disorder on distress and discomfort tolerance levels as well as dysfunctional attitudes on individuals with this disorder. Method: In our study, 218 people were interviewed in total. People who could possibly have PMDD according to Premenstrual Symptoms Screening Tool (PSST) were monitored for 8 weeks and 31 people were diagnosed with PMDD. People without PMDD and having under threshold symptoms for PMDD according to PSST who have matching age and BMI were also included in the study. Distress Tolerance Scale (DTS), Discomfort Intolerance Scale (DIS), Dysfunctional Attitude Scaleshort forms (DAS-sf) were filled for each sample. Results: DTS self-efficacy scores were found to be higher in group without PMDD than the groups with PMDD and having under threshold symptoms. DAS-total score was found to be higher in group with PMDD than the groups without PMDD group and having under threshold symptoms group. Discomfort avoidance subscale score of distress tolerance scale was found to be higher compared to participants without PMDD and participants having below threshold symptoms. Discussion: Women with PMDD may benefit from preventive treatment modalities that minimize discomfort and avoidance behaviours and facilitate their coping with negative bodily sensations of premenstrual syndrome and prevent the development of dysfunctional attitudes toward these bodily and mental disturbing sensations.Item Majör depresif bozukluk tanısı almış hastalarda serum lipid profili, homosistein, fibrinojen ve oksidan-antioksidan sistem belirteçlerinin düzeyleri ve antidepresan tedaviye bağlı değişimleri(Uludağ Üniversitesi, 2009) Kotan, Vahap Ozan; Kırlı, Selçuk; Uludağ Üniversitesi/Tıp Fakültesi/Psikiyatri Anabilim Dalı.Epidemiyolojik çalışmalar, sağlıklı ve kalp–damar hastalığı (KDH) olan bireylerde ortaya çıkan kardiyak sorunların insidansı ile majör depresif bozukluk (MDB) arasında anlamlı bir ilişki olduğunu göstermektedir. MDB hastalarında KDH riskinin, hem MDB hem de KDH gelişimine sebep olabilen, altta yatan ortak fizyolojik etkenlerin sonucunda olabileceği üzerinde durulmaktadır. Serum lipid düzeyleri, oksidatif stres, inflamasyon ve koagülasyon eğiliminde artma her iki hastalığın ortaya çıkmasıyla ilişkili görünen etkenler arasındadır. Bu çalışmada MDB ve KDH patofizyolojilerinde ortak görünen etkenlerden serum lipid profili, homosistein, fibrinojen ve oksidan–antioksidan sistem belirteçlerinin düzeyleri ve bu düzeylerin antidepresan (AD) tedaviden nasıl etkilendiğinin belirlenmesi amaçlanmıştır. Bu amaçla, MDB tanısı alan 50 hasta ile 44 sağlıklı gönüllü çalışmaya alınmıştır. İlk değerlendirmeyi takiben AD tedavi başlanarak 6., 12. ve 24. haftalarda kontrol değerlendirmeleri yapılmıştır. Çalışma sonuçlarına göre MDB ile lipid profili, homosistein ve fibrinojen düzeyleri ilişkisiz görünmektedir. MDB hastalarının oksidan–antioksidan sistem belirteçlerinde ortaya çıkan farklılıklar, MDB patofizyolojisinde ve KDH ile bağlantısında oksidatif stresin yer aldığını desteklemektedir. Uzun dönem AD tedavinin A vitamini ve yüksek yoğunluklu lipoprotein (HDL) düzeylerinde artma, bazal malondialdehid (B_MDA) ve plazma malondialdehid (pMDA) düzeylerinde azalma, paraoksonaz ve arilesteraz aktivitelerinde artma şeklinde saptanan sonuçları KDH riskini azaltıcı; vücut kitle indeksi (VKİ), kolesterol, fibrinojende artma ve total antioksidan kapasitede azalma şeklindeki sonuçları ise KDH riskini arttırıcı yöndedir. MDB hastalarının AD tedavi ve takip süreçlerinde antioksidan besinlerin tüketilmesi ve kilo alımının önlenmesiyle KDH riski azaltılabilir.Item Pain, daytime sleepiness, anxiety and depression levels of patients with chronic neuropathic pain syndromes(Ege Üniversitesi Tıp Fakültesi, 2015-12-08) Kotan, Zeynep; Kotan, Vahap Ozan; Demir, Aylin Bican; Bora, İbrahim; Özkaya, Güven; Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0003-0297-846X; 0000-0001-6739-8605; A-4421-2016; V-7170-2017; 18036596400; 6602914249; 16316866500Objective: The current study aims to determine pain, daytime sleepiness, anxietyand depression levels of patients with chronic neuropathic pain and compare different clinical conditions causing neuropathic pain in terms of these variables. Method: 241 patients (105 patients with diabetic neuropathy, 39 patients with fibromyalgia, 27 patients with carpal tunnel syndrome, 27 patients with radiculopathy, 22 patients with trigeminal neuralgia and 21 patients with postherpetic neuralgia) were included in the study. The assessments were performed using socio-demographic data form, Visual Analog Scale (VAS), Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), Epworth Sleepiness Scale (ESS) and Hospital Anxiety and Depression Scale (HAD). Results: Evaluation of pain with VAS and LANSS showed no statistical difference among subgroups. Scores of LANSS and VAS were positively correlated with each other. ESS scores were found to be above the cut-off point (> 10) in all subgroups. LANSS, but not VAS scores were positively correlated with ESS scores. Depression scores were above the cut-off point (> 7) in diabetic neuropathy, fibromyalgia and trigeminal neuralgia groups and anxiety scores were above the cut-off point (> 10) in diabetic neuropathy, fibromyalgia, trigeminal neuralgia and carpal tunnel syndromegroups. No correlation was found between scores of both VAS and LANSS and scores of HADS. Depression scores correlated positively with ESS scores (r=0.153, p<0.05). Conclusions: Daytime sleepiness, depression and anxiety are associated comorbidities with different neuropathic pain syndromes. Neuropathic character, but not the intensity of pain is associated with daytime sleepiness. Pain intensity does not predict anxiety and depression levels. Depression, but not anxiety shows a positive correlation with daytime sleepiness. These results might have implications for the better understanding of comorbidities in different neuropathic pain syndromes.Item Psychopathology, psychosocial factors and quality of life in patients with myasthenia gravis(Journal of Neurological Sciences, 2016-08-11) Kotan, Vahap Ozan; Kotan, Zeynep; Aydın, Birgül; Yalvac, Hayriye Dilek; Taşkapılıoğlu, Özlem; Karlı, Hamdi Necdet; Özkaya, Güven; Sarandöl, Aslı; Turan, Ömer Faruk; Kırlı, Selçuk; Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Psikiyatri Anabilim Dalı.; 0000-0003-0297-846X; A-4421-2016; AAK-6623-2020; 23037226400; 57193973560; 16316866500; 14020405100; 23037113500; 14019745700Introduction: Myasthenia Gravis (MG) is a chronic disease which affects physical, psychological and social functioning of patients. In this study we aim to determine psychiatric comorbidity, some psychosocial factors and their relations with quality of life in patients with MG. Methods: A total of 52 patients underwent psychiatric examination and the following scales were applied: Socio-demographic data form, Hospital Anxiety and Depression Scale (HADS), Quality of Life (QOL) Scale Short Form 36 (SF-36), Psychosocial Adjustment to Illness Scale-Self report (PAIS-SR), Multidimensional Scale of Perceived Social Support (MSPSS) and Posttraumatic Growth Inventory (PTGI). Results: Among 52 patients with MG, 36.5% (n=19) had no psychiatric diagnosis; 21.2% (n=11) had adjustment disorder; 19.2% (n=10) had depression and 23.1% (n=12) had anxiety disorder. Patients with a psychiatric diagnosis had lower scores in general health, vitality, social functioning, emotional role and mental health domains of SF-36. PAIS-SR scores, total MSPSS and friends scores were signifitcantly higher in patients without a psychiatric diagnosis. Significant correlaions of psychosocial factors with quality of life were determined. Conclusion: In MG patients, there is a high prevalence of psychopathology and it is associated with quality of life, perceived social support and psychosocial adjustment of the patients. Quality of life is reduced in both physical and mental aspects. Diagnosis and treatment of psychopathology in MG patients is crucial to decrease disease burden.Item The relationship between internalized stigma and treatment motivation, perceived social support, depression and anxiety levels in opioid use disorder(Taylor and Francis, 2018) Akdağ, Emine Merve; Kotan, Vahap Ozan; Köse, Samet; Tıkır, Baise; Aydemir, Makbule Çiğdem; Okay, İhsan Tuncer; Göka, Erol; Özkaya, Güven; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı; 0000-0003-0297-846X; A-4421-2016; 16316866500OBJECTIVE: This study aims to examine how internalized stigma differs in opioid use disorder (OUD) based on sociodemographic and clinical variables, and to what extent internalized stigma is related to treatment motivation, perceived social support, depression, and anxiety levels. METHODS: One hundred forty-five individuals with OUD included. Sociodemographic and clinical data form, the Internalized Stigma of Mental Illness Scale (ISMI), Treatment Motivation Questionnaire (TMQ), Multidimensional Scale of Perceived Social Support, the Beck Depression Inventory, and the Beck Anxiety Inventory were utilized in the study to collect data. Bivariate and partial correlation coefficients between variables were computed. ISMI and TMQ scores were compared between patients with depressive symptoms and patients without depressive symptoms by using t-test and Mann Whitney U test. RESULTS: Internalized stigma was high among male patients with heroin use disorder. There was a positive correlation between internalized stigma score and treatment motivation, depression, and anxiety levels. On the other hand, there was a negative correlation between internalized stigma score and multidimensional perceived social support. CONCLUSION: Internalized stigma occupies an important place in the treatment of OUD, which occurs with frequent relapses and which is hard to treat. Not only application for treatment but also adherence to treatment and treatment motivation at maintenance phase bestow a complicated relationship with depression and anxiety. In the struggle against internalized stigma, it plays a vital role to mobilize people's social support systems, to educate families on the issue and to get in touch with support units exclusive to heroin users.Item Serum glial cell line-derived neurotrophic factor levels and impulsivity in heroin addiction: a cross-sectional, case-control study of 129 heroin addicts(Aves, 2018) Kotan, Vahap Ozan; Yüksel, Rabia Nazik; Kotan, Zeynep; Okay, İhsan Tuncer; Topçuoğlu, Canan; Bayram, Şenol; Göka, Erol; Özkaya, Güven; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0003-0297-846X; A-4421-2016; 16316866500OBJECTIVE: Glial cell line-derived neurotrophic factor (GDNF), being a protective of dopaminergic neurons, is reported to modulate addictive behaviours and have a role as a negative regulator for biochemical and behavioural adaptations to drug abuse. We aimed to reveal impulsivity and serum GDNF levels in patients with heroin addiction and investigate their relationships in order to contribute to the understanding of behavioural aspects and biological mechanisms in heroin addiction via this study. METHODS: This study was performed at the Department of Psychiatry of Ankara Numune Training and Research Hospital, Turkey. We recruited 129 heroin-dependent patients and 90 age, sex, and smoking-matched healthy controls with no major psychopathology. Barratt Impulsivity Scale-11, Hospital Anxiety and Depression Scale (HADS) and sociodemographic data form were applied to all participants. Laboratory analysis for serum GDNF levels was performed for each participant's blood sample. RESULTS: Total impulsivity scores and scores of Attentional Impulsivity, Motor Impulsivity, and Unplanned Impulsivity subscales were all higher in heroin addicts compared to the controls. Heroin addicts had also lower serum GDNF levels and lower GDNF levels were associated with high impulsivity and high HADS scores in heroin addicts. CONCLUSION: Decrement in GDNF levels in heroin addiction seems as to be an important data which could be associated with impulsivity, anxiety, and depressive symptoms. GDNF could find a prominent place among the target molecules in the treatment of heroin addiction.Item Thiol/disulphide homeostasis in bipolar disorder(Elsevier Ireland, 2017-12-30) Erzin, Gamze; Kotan, Vahap Ozan; Topçuoğlu, Canan; Erel, Özcan; Yüksel, Rabia Nazik; Ürer, Emre; Aydemir, Makbule Çiğdem; Göka, Erol; Özkaya, Güven; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0003-0297-846X; A-4421-2016; 16316866500Bipolar disorder (BD) patients have increased oxidative stress, which can disturb thiol/disulphide homeostasis, causing disulphide formation. The aim of the study is to investigate dynamic thiol/disulphide (SH/SS) homeostasis in BD patients, which is a novel evaluation method of oxidative status. Ninety-four BD patients (50 in the manic episode and 44 in remission) and 44 healthy controls were included in the study. Blood serum native thiol (SH) and total thiol (ToSH) concentrations were measured in a paired test. The half value of the difference between native thiol and total thiol concentrations was calculated as the disulphide (SS) bond amount. Serum native thiol levels of the mania group were found to be lower than the remission and the control groups. There was a significant difference between the remission group and the control group in terms of native thiol. Serum total thiol level was lower in mania group than the control group. Detection of oxidative molecules for BD could be helpful, especially in treatment, follow-up periods and reducing morbidity. The results of our study besides the data available in the literature support that thiol and disulphide levels are useful markers for BD and promising therapeutic targets in terms of future pharmacological modulation.