Person: AKKAYA, CENGİZ
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AKKAYA
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CENGİZ
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Publication The role of clozapine as a mood regulator in the treatment of rapid cycling bipolar affective disorder(Turkiye Sinir Ve Ruh Sagligi Dernegi, 2019-12-01) Kılıçel, Oğuzhan; Kılınçel, Şenay; Gündüz, Cem; Cangür, Sengül; Akkaya, Cengiz; AKKAYA, CENGİZ; Bursa Uludağ Üniversitesi/Tıp Fakültesi; ABI-3174-2020Objective: In this study, we aimed to investigate the effect of the clozapine on the course of the rapid cycling Bipolar Affective Disorder.Method: The study group was formed with the patients aged between 18 and 65 years of age, who met the criteria for the diagnosis of Bipolar Affective Disorder according to the Diagnostic and Statistical Manual of Mental Disorders 4th Edition, with rapid cycling characteristics. Variables like the number of mania and depressive episodes, the days spent in mania and in depression and the number of hospitalization and attempted suicide, in the year before starting clozapine were determined and compared with the annual data after starting the clozapine.Results: Eleven female and two male patients who met the inclusion criteria were included in this study. The group's average daily use of clozapine was 180 mg (25-600 mg). There was a statistically significant difference in the number of days spent in the depression, the days spent in the mania, the number of depressive episodes and manic episodes, the number of hospitalizations and the suicide attempts after the clozapine use.Conclusion: In this study, it was determined that clozapine was effective as a mood stabilizer in Bipolar Affective Disorder treatment. The results show that clozapine reduces the episode frequency and the duration in rapid cycling Bipolar Affective Disorder which does not respond to all conventional treatments, including lithium, valproic acid, carbamazepine and antipsychotic drugs.Publication The efficacy of flupenthixol decanoate in bipolar disorder patients who have no sufficient remission with existing treatments(Cumhuriyet Üniversitesi Tıp Fak Psikiyatri Anabilim Dalı, 2015-10-01) Eker, Salih Saygın; Akkaya, Cengiz; Pirinçci, Erdal; Cangür, Şengül; Kırlı, Selçuk; EKER, SALİH SAYGIN; AKKAYA, CENGİZ; Pirinçci, Erdal; KIRLI, SELÇUK; Uludağ Üniversitesi/Tıp Fakültesi/Ruh Sağlığı ve Hastalıkları Anabilim Dalı; Q-9477-2019; EKJ-8427-2022; FVU-0359-2022; CZU-1387-2022Objective: It is aimed to evaluate the prophylactic effect of flupenthixol decanoate in remitted BD patients. Methods: Remitted patients with bipolar disorder (BD), who had at least one mood episode each year in the last five years in spite of adequate pharmacotherapy, were included. Flupenthixol decanoate 20 mg/ml was administered in every two weeks. Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS), Bipolar Disorder Functioning Questionnaire (BDFQ), General Assessment of Functionality (GAF) and Side Effect Rating Scale (UKU) were applied. Patients were followed up for 12 months. Results: Eight patients with a mean age of 34.7 +/- 7.5 were enrolled to the study. None of the patients were under monotherapy before the study enrollment. Three (37.5%) of the three patients were dropped out. The data of remaining 5 patients' were evaluated. At the end of the study mean number of mood episodes declined to 0.2 +/- 0.4 per year indicating a statistical significance and the mean score of BDFQ declined to 119.6 +/- 2.7. Conclusions: Flupenthixol decanoate significantly improved functionality and decreased the number of mood episodes allowing an alternative treatment even in remitted BD patients.Publication Sleep measurements in women with dysthymic disorder and insomnia(Springer, 2015-01-01) Kotan, Zeynep; Bican, Aylin; Kotan, Vahap Ozan; Bora, İbrahim; Yalvac, Hayriye Dilek; Özkaya, Güven; Akkaya, Cengiz; BİCAN DEMİR, AYLİN; BORA, İBRAHİM HAKKI; ÖZKAYA, GÜVEN; AKKAYA, CENGİZ; Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Psikiyatri Anabilim Dalı.; 0000-0003-0798-4850; 0000-0002-1456-2499; A-4421-2016; ENI-7759-2022 ; CEN-7664-2022; EKJ-8427-2022To determine the effects of trazodone, mirtazapine and hydroxyzine on sleep profiles of dysthymic disorder (DD) women with selective serotonin reuptake inhibitor (SSRI) treatment and compare their polysomnographic measurements with controls. Among 36 patients trazodone receiving (n=9), mirtazapine receiving (n=8), hydroxyzine receiving (n=8) and only SSRI receiving (n=11) patients were compared to each other and to controls in terms of polysomnographic (PSG) findings. Rapid eye movements (REM) ratio and sleep onset time (SO) were higher; slow wave sleep (non-REM3) ratio and total sleep duration (TSD)) and sleep efficiency (SE) were lower in patients when compared with controls. Increased REM ratio and SO; decreased non-REM3 ratio and TSD and SE were found in both only SSRI receiving patients and hydroxyzine receiving patients when compared with controls. Only SSRI receiving patients also showed increased non-REM1 ratio. Trazodone or mirtazapine receiving patients showed no difference than controls. When PSG assessment is considered, it can be suggested that both trazodone and mirtazapine improve sleep problems in DD patients with SSRI treatment, but hydroxyzine does not.Publication The factors affecting the level of patients' satisfaction of the applicants for emergency service(Wolters Kluwer Medknow Publications, 2012-04-25) Akkaya, Esra Gültekin; Bulut, Mehtap; Akkaya, Cengiz; AKKAYA, CENGİZ; Uludağ Üniversitesi/Tıp Fakültesi/Psikiyatri Anabilim Dalı.; EKJ-8427-2022ObjectivesThe aim of this study was to evaluate the satisfaction levels of patients of the emergency service at Uludag University Medical Faculty Hospital, to analyze associated factors, and to suggest improvements for the future.MethodsPatients of the emergency service between May 1 and June 30, 2008 who were over 18 years old were included in this study. Via a questionnaire, patients were asked about their level of satisfaction with emergency service doctors, nurses and staff; the level of information provided; the length of their examinations; the physical state of the hospital; and the quality of technical equipment at the hospital.ResultsA total of 600 patients were enrolled in the study. The average age was 40.7 +/- 16.6 years, and 51.2% of the patients were male. Of the patients, 76.2% were discharged directly without waiting at the emergency service; 45.3% of the 64 patients who were hospitalized waited at the emergency service before being admitted. Patients were 94.5% satisfied with the experience levels of emergency service doctors and 91% satisfied with the experience levels of the nurses.ConclusionsThe major factors affecting patient satisfaction levels are the attitudes and medical care experience levels of doctors and nurses in charge at the emergency service and the level of information provided to patients throughout treatment and waiting periods.Publication Metabolic, endocrinologic and cardiac effects of amisulpride: A 24-week follow-up study(Sage Publications Ltd, 2011-12-01) Kotan, Zeynep; Ertepe, Berrin; Akkaya, Cengiz; SARANDÖL, EMRE; AKKAYA, CENGİZ; Sarandöl, Emre; Özkaya, Güven; ÖZKAYA, GÜVEN; Kirli, Selçuk; KIRLI, SELÇUK; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Psikiyatri Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyokimya Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0003-0297-846X; A-4421-2016; ABE-1716-2020Background: Amisulpride is a second-generation antipsychotic which has been proved to be effective in the control of both positive and negative symptoms of schizophrenia. In this study we aimed to determine metabolic, endocrinologic and cardiac effects of amisulpride commonly used in our clinical practice.Methods: A total of 18 patients (11 males, 7 females) diagnosed with schizophrenia received amisulpride at the dosage of 800 mg/day and were followed up for 24 weeks. Positive and negative psychotic symptoms, extrapyramidal and sexual side effects, metabolic, endocrinologic and cardiac parameters were evaluated at regular intervals.Results: Significant improvement in both positive and negative symptoms was observed in patients starting from the second week of treatment. Prolactin levels increased significantly both in men and women starting from the measurement on day 4. Prolactin elevation was significantly higher in women than in men. Increase in total cholesterol level became significant at week 24. No other significant difference was observed between weeks 1 and 24 regarding the other parameters.Conclusions: The clinical data from the present study supports the fact that amisulpride is an effective and safe antipsychotic drug, but elevates prolactin levels in both sexes.Publication Clozapine as a mood stabilizer in the treatment of rapid cycling bipolar affective disorder(Elsevier, 2019-01-01) Akkaya, C.; Kılıçel, M. O.; AKKAYA, CENGİZ; Uludağ Üniversitesi/Tıp Fakültesi/Psikiyatri Anabilim Dalı; EKJ-8427-2022Publication Evaluation of life quality in epilepsy patients and review of psychiatric diagnosis(Kare Publ, 2018-01-01) Bican Demir, Aylin; BİCAN DEMİR, AYLİN; Uzun Uslu, Pınar; Atasayar, Gülfer; Kılınçel, Oğuzhan; Akkaya, Cengiz; AKKAYA, CENGİZ; Bora, Ibrahim; BORA, İBRAHİM HAKKI; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Psikiyatri Anabilim Dalı.; 0000-0001-6739-8605; V-7170-2017; JCE-6657-2023; ABI-3174-2020Objectives: In patients with epilepsy, the level of harmony and balance between life expectancy and physical, psychological, and social limitations determines the level of quality of life. Our aim in this study was to determine the quality of life and psychiatric diagnoses in patients with epilepsy and to investigate the effects they have on anxiety and depression.Methods: This study comprised 161 patients with epilepsy, whose anamnesis, neuroimaging, electroencephalography (EEG), neuropsychometric tests and psychiatric consultations took place at the epilepsy clinic. A 36-Item Short Form Survey (SF-36) life scale, Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HDRS) were applied to the patients.Results: Of the seizures, 30% (49/161) were found to be generalized onset tonic-clonic-myoclonic seizures, 29% (48/161) were focal onset motor seizures, 23% (35/161) were focal onset bilateral tonic-clonic seizures, and 18% (29/161) were focal onset non-motor seizures. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), 41 patients had depressive adjustment disorder, 38 patients had major depressive disorder, 12 patients had conversive disorder, 12 patients had dysthymic disorders, five patients had mild mental retardation, four patients had psychological mental disorders, which could not be otherwise specified, and three patients had obsessive-compulsive disorder.Conclusion: The most common psychiatric disorders in epilepsy are known to be affective diseases, particularly depression (9-22%). In our study, depression was the most common comorbid condition in patients, and it was noteworthy that a significant loss was apparent regarding the patients' quality of life as results of the quality of life scale showed. To identify the accompanying social and psychiatric disorders of patients and to consult with psychiatry when necessary during follow-up are as important as seizure control for increasing the quality of life of patients.Publication Epworth sleepiness scale and polysomnographic evaluation of dysthymic women with chronic insomnia(Turkish Neurological Soc, 2010-01-01) BİCAN DEMİR, AYLİN; Bican, Aylin; Kotan, Ozan Vahap; Bora, Ibrahim; BORA, İBRAHİM HAKKI; Akkaya, Cengiz; AKKAYA, CENGİZ; Carkungöz, Ender; UZABACI, ENDER; Kırlı, Selçuk; KIRLI, SELÇUK; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Pskiyatri Anabilim Dalı.Objective: In patients with dysthymic disorder (DD), sleep problems are assessed as a part of their depressive state, and different treatable conditions, such as other primary sleep disorders, are often skipped. We aimed to determine symptoms related to daytime sleepiness and polysomnographic findings in dysthymic women with chronic insomnia and to find out whether or not there is an accompanying sleep disorder. We suggest that pathologies that can lead to sleep problems in dysthymic patients should be searched, and to this end, application of the Epworth sleepiness scale (ESS) and polysomnography examination should be used much more frequently.Patients and Methods: We included 20 female dysthymic patients with complaints of chronic sleep problems who had been under follow-up at Uludag University Hospital Psychiatry Outpatient Clinic for at least the last two years. Twenty healthy female volunteers, aged 18-65 years, were included in the study as the control group. ESS and polysomnography examination were applied in all patients.Results: When patients with DD and healthy controls were compared, significant differences in ESS scores and ratios of sleep phases were determined between groups. DD patients had higher ESS scores and higher ratios of rapid eye movements (REM), non-REM-1 (Stage 1), non-REM-2 (Stage 2) phases and lower ratios of slow wave sleep (Stage 3 + Stage 4).Conclusion: The findings of our study suggest that there are structural sleep changes in dysthymic patients, but no direct connection between sleep variables and depressive states is evident.Publication Bipolar disorder with thrombophilia: A case report of possible association(Universitatsverlag Ulm Gmbh, 2008-01-01) Akkaya, Cengiz; AKKAYA, CENGİZ; Taşkapılıoğlu, Özlem; Gündüz, Cem; Seferoğlu, Meral; Hakyemez, Bahattin; HAKYEMEZ, BAHATTİN; Kırlı, Selcuk; KIRLI, SELÇUK; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Psikiyatri Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Nöroloji Anabilim Dalı.; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Radyoloji Anabilim Dalı.; 0000-0003-4436-3797; 0000-0003-3858-0306; AAI-2318-2021; AAK-6623-2020A 26-year-old female who had an 8-year history of BD was hospitalized due to manic episode. Because of the ischemic lesions on the cranial resonance imaging and pyramidal tractus signs in the neurological examination, a comprehensive etiologic diagnostic work-up including consultation of the patient by the Rheumatology Department for the differential diagnosis of vasculitis was suggested by the consultant neurologist. Abnormal findings were heterozygotic fVL and MTHFR mutations and decreased Protein S level. Because of positive test results for thrombophilia factors, the Hematology Department consulted the patient and put her on acetylsalicylic acid 100 mg/day treatment. To our knowledge, this is a singular report of a case which suggests an association between thrombophilia, stroke, and BD. But answers to questions "Is BD caused by silent stroke?" and "Does silent stroke complicate the clinical picture of this patient?" in this case are not straightforward and confusing. It should be kept in mind that human being is a biopsychosocial entity. The patients should be evaluated globally not to stick on their signs only. This will result in the exact diagnosis of the patients providing them with accurate treatment that improves their quality of life.Publication Comparison of effects of sertraline and reboxetine on the loss of social functioning in major depressive disorder: A randomized, open-labeled study(Kare Yayınevi, 2006-01-01) Akkaya, Cengiz; Sivrioğlu, E. Yusuf; Sarandöl, Aslı; Eker, S. Saygın; Kırlı, Selçuk; AKKAYA, CENGİZ; SİVRİOĞLU, ENVER YUSUF; SARANDÖL, ASLI; EKER, SALİH SAYGIN; KIRLI, SELÇUK; Uludağ Üniversitesi/Tıp Fakültesi/Psikiyatri Anabilim Dalı.; Q-9477-2019; EKJ-8427-2022; GBQ-8020-2022; FTX-6743-2022; CZU-1387-2022Objective: In this study we aimed to compare the effects of sertraline and reboxetine, which are influential on two different neurotransmitters, on social functioning.Method: 41 patients conforming to the study protocol and who met DSM-IV MDD diagnostic criteria were recruited for the study. These subjects were distributed randomly into two groups, sertraline and reboxetine. The subjects were assessed six times during the study which lasted 11 weeks. At each assessment the subjects were asked to complete "Hamilton Depression Rating Scale" (HDRS), "Montgomery-Asberg Depression Rating Scale" (MADRS) and "Social Adaptation Self-evaluation Scale (SASS).Results: In both groups, the decrease in HDRS and MADRS scores was found to be statistically significant starting from the 2nd visit, compared to the values prior to medication. The decrease in SASS scores, on the other hand, was significant starting from the 3rd visit. In comparison of reboxetine and sertraline groups, HDRS scores were found to be significantly higher in the reboxetine group in visits 2, 3, and 4. However, no significant difference was found in MADRS and SASS scores.Discussion and Conclusion: In this study two antidepressants which create a selective effect via serotonin and noradrenalin were compared and it was found that clinically an earlier response and remission was provided with reboxetine. Nevertheless, it is notable that there was no statistically significant difference on their social functioning levels.