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Yayın Relationship between metabolic syndrome and clinical features, and its personal-social performance in patients with schizophrenia(Springer, 2016-06) Saatçioğlu, İbrahim Ömer; Kalkan, Murat; Fıstıkçı, Nurhan; Erek, Şakire; Kılıç, Kasım CandanThe aim of this study was to evaluate the metabolic syndrome (MS) criteria and also to investigate the effects of MS on medical treatment, clinical course and personal and social performance in patients with schizophrenia. One hundred-sixteen patients with schizophrenia were included in the study. Measurements of MS were calculated in all patients. Brief Psychiatric Rating Scale, Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, Calgary Depression Scale for Schizophrenia, Personal and Social Performance Scale (PSP) were applied. The frequency of MS according to IDF criteria was 42.2 % among the patients. There was no significant difference between patients with and without MS in terms of age. The ratios of MS were 62.5 % for the group taking typical and atypical antipsychotics together and 35.7 % for the group taking two or more atypical antipsychotics together. The duration of disorder in patients with MS was higher than those without MS. Furthermore there was no significant difference between the schizophrenic patients with and without MS, in terms of PSP scores. Our findings showed that the duration of illness, high scores of BMI, use of clozapine or concurrent use of typical and atypical antipsychotics, depressive and negative symptoms of schizophrenia were significant risk factors for the development of MS.Yayın A clinical case of treatment-resistant schizophrenia: 60 hospitalizations and 342 ECT sessions in 36 years; lack of social support or undertreatment?(İstanbul Üniversitesi, 2015-06) Cesur, Ender; Fıstıkçı, Nurhan; Dönmezler, Fadime Gizem; Saatçioğlu, İbrahim ÖmerIt is reported that between 20% and 25% of patients have schizophrenia that is resistant to treatment. The treatment resistance in schizophrenia is defined by many authorities. One of the generally accepted definitions is inadequate response despite treatment with different atypical antipsychotics, two or three times at least four-six weeks; the other acceptable one is although the use of two different typical or atypical antipsychotics in monotherapy during four-six weeks, inadequate treatment response is obtained. Duratian of hospitalization in treatment resistant cases is longer. In addition, when considering all the expenses and loss of functions, the cost of resistant cases to society is higher. 60 years old, women patient. She was hospitalized from emergency department where she came with his son, because of denial of treatment and homicidal intent. It is learned that age of onset was 24, disease began in a postpartum period, she was diagnosed with schizophrenia and she had 60 hospitalizations. Although clozapine, haloperidol, amisulpiride, risperidone, olanzapine, aripiprazole, quetiapine, chlorpromazine, sulpiride, zuclopenthixol, fluphenazine, lithium and valproate were used adequate doses and time; a total of 342 ECT sessions were administered; response or partial response was achieved, she had not achieved long-term functioning and well-being. In the most recent admission, she had significant improvement with clozapine 275 mg/day and valproat 1000 mg/day. Despite all treatment efforts, schizophrenic patient with excessive admissions and frequent recurrences is discussed.
