Browsing by Subject "REMISSION"

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    What Does the Subjective Assessment of Cognitive Functioning Measure in Bipolar Disorder? Correlation with the Objective Assessment of Cognitive Functioning
    (TURKIYE SINIR VE RUH SAGLIGI DERNEGI) Aydemir, Ö; Kaya, E
    Objective: Even in remission, cognitive deficits are frequently observed in bipolar disorder Because these deficits are assessed with complex and comprehensive tests, they seem to be neglected in routine daily practice, however assessing them with short self-rated questionnaires could be beneficial. This study aimed to investigate the correlation between objective and subjective cognitive assessment in bipolar disorder. Method: The study included 38 patients with bipolar disorder that were in remission for at least 6 months and 19 healthy controls. The Stroop Test and Auditory Verbal Learning Test were used for the objective assessment of cognitive functioning, and the cognitive functioning subscale of the Bipolar Disorder Functioning Questionnaire was used for the subjective assessment of cognitive functioning. Mood symptoms were assessed using the Hamilton Depression Rating Scale and Young Mania Rating Scale. Results: Based on objective assessment there were significant differences in all domains of the Auditory Verbal Learning Test between the bipolar patients and healthy controls, whereas there weren't any significant difference in Stroop Test results. Based on subjective assessment there were significant differences between the bipolar patients and healthy controls in terms of cognitive functioning subscale total score and first item score, but not in terms of the other items. When the correlation between the objective and subjective cognitive assessments was investigated, total score of the cognitive functioning subscale and 2 items-1. to run simple calculations in one's mind and 2. gathering and performing what one is asked to do-were moderately to weakly correlated with immediate recall, verbal learning, recognition, retrieval, and reading shape color No correlation was observed between the other items of the cognitive functioning subscale. Conclusion: Based on subjective assessment of cognitive functioning, the bipolar patients tended to over-estimate themselves. Furthermore, bipolar patients tended to report more deficits correlated with objective cognitive assessment when they had to display active performance, whereas they did not report cognitive deficits at this level when such a condition was not present.
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    Evaluation of psychosocial functioning in the acute treatment term of major depressive disorder: A 16-week multi-centered follow-up study
    (ELSEVIER) Altunsoy, N; Dikici, DS; Cökmüs, FP; Özkan, HM; Ascibasi, K; Alçi, D; Kuru, E; Yüzeren, S; Aydemir, O
    Objective: Major depressive disorder is the leading cause of non-fatal burden, and disability in adulthood. Even though depression is well-treated in the acute term,psychosocial functioning does not get back to the premorbid level most of the time. In this present study, it is aimed to evaluate the outcome of the acute term treatment of major depressive disorder in terms of psychosocial functioning. Methods: The study is an open-label, observational, multi-center follow-up study for four months of patients with major depressive disorder according to DSM-5. Patients were evaluated with Montgomery Asberg Depression Rating Scale (MADRS), Sheehan Disability Scale (SDS) and Short Form-36 (SF-36) at the beginning, and at the 2., 4., 8., 12. and 16.weeks. Results: 100 patients were invited to the study and 56 patients completed the study.As a result of the treatment, the mean MADRS and SDS scores decreased significantly. All domains of SF-36 were improved significantly with the treatment. Unfortunately patients suffering from MDD could not reach the normative data,especially on the domains of social functioning, role emotional, pain, and general health perception. Treatment outcomes show that SNRI users presented higher scores on the domains of pain and physical functioning. However SSRI users showed better outcomes on the domains of mental health and vitality. Conclusion: Our research corroborated that even patients gain symptomatic remission in MDD treatment, psychosocial dysfunction persists. It is also concluded that different antidepressant options may act differently on treatment outcomes.
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    Factor structure of the Subjective Well-being under Neuroleptic treatment Scale-short form in schizophrenic outpatients: Five factors or only one?
    (INFORMA HEALTHCARE) Pazvantoglu, Ö; Simsek, ÖF; Aydemir, Ö; Sarisoy, G; Böke, Ö; Üçok, A
    Backround and aim: The Subjective Well-Being under Neuroleptics Scale, short form (SWNS), is a self-report measure that evaluates the states of well-being of schizophrenia patients using antipsychotic drugs independently from psychopathology of disease. This study examined the factor structure of the Turkish version of the scale using high-level statistical analyses. Methods: The SWNS was translated into Turkish and applied to 103 schizophrenic patients. A type of multi-trait-multi-method (MTMM) confirmatory factor analysis was conducted to determine the factor structure of the Turkish version of the scale. Results: The results of factor analysis of the SWNS were incompatible with the factor structure of the original scale. A set of MTMM analyses showed distinct method effects for both positive and negative item wording in the scale. In light of these findings, the factor structure of the SWNS was determined as having a one-dimensional structure, with bias due to item wording. Conclusions: The results of the present investigation indicated that the sub-factors of the SWNS failed to emerge from the data. This study is the first to show that there is an urgent need for further examination of the factor structure of the SWNS with regard to method effects. This issue has important implications for the use of sub-factors by both researchers and practitioners.
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    Therapeutic goals, clinical indicators and follow up in major depressive disorder
    (KURE ILETISIM GRUBU A S) Aydemir, Ö
    Major depressive disorder constitutes a very important health problem because of its associated disability. The treatment plan for depression should included targets, since the better the goals are described, the more likely the treatment will be followed up and monitored. For this purpose, clinical psychiatric scales are useful. Psychiatric rating scales are instruments to monitor depression and its treatment in a useful and operational way. Response may be the most important criterion to be monitored and is defined as a 50% reduction in the index scale score. Inadequate response to the treatment is defined as a 25-50% reduction and no response to treatment is defined as a reduction below 25%. Remission is defined as the improvement of most symptoms and during the monitoring of remission the target response is a score below the cutoff score, e.g. reduction of the Hamilton Depression Rating Scale below 7 and reduction of the Montgomery Asberg Scale below 10. While these two scales are the most used instruments in monitoring the treatment of depression, self-rated scales, while less preferred, may also be used. In the global assessment of patients, the Clinical Global Impression scale may be used. The achievement of remission in depression lowers health-care costs significantly, reduces disease burden, improves quality of life, and reduces medical and psychiatric morbidity and mortality. Even though the functionality of patients improves,when assessed subjectively, it is not possible to suggest that it reaches premorbid levels; thus, in the follow-up of patients, functionality should be monitored, as well as response and remission.
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    Reliability and Validity Study of the Turkish Version of Functioning Assessment Short Test in Bipolar Disorder
    (TURKIYE SINIR VE RUH SAGLIGI DERNEGI) Aydemir, Ö; Uykur, B
    Objective: There is a need for instruments to assess the Functioning Assessment Short Test practically. In this study the goal was to to perform a reliability and validity analyses of the Functioning Assessment Short Test (FAST) in bipolar disorder. Method: The study was harbored 70 patients with bipolar disorder and 134 healthy control subjects. Thirteen of the patients were in the manic episode, 16 were in the depressive episode, and 41 patients were in remission. First, FAST was translated into Turkish and then it was back-translated into English. The translation was finally approved by the author of the original development study. In the concurrent validity, Bipolar Disorder Functioning Questionnaire (BBi) was used. Results: In the reliability analyses, Cronbach alpha coefficient of internal consistency was calculated to be 0.960, and test-retest reliability coefficient was found to be 0.945. In the validity analyses, in the exploratory factor analysis five factors were obtained and the factor represented social functioning, occupational functioning, autonomy, cognitive functioning and financial issues. In the confirmatory factor analysis, comparative fit index was 0.912 and RMSEA value was 0.085. In the concurrent validity analyses, the domains of FAST were correlated poorly to moderately with the subscales of BBi. FAST discriminated bipolar patients with symptomatic episodes and remitted patients, healthy controls. The area under the ROC curve was found to be 0.824. Conclusion: These results point out that the Turkish version of Functioning Assessment Short Test can used reliably and validly in bipolar patients.
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    A national, multicenter, secondary data use study evaluating efficacy and retention of first-line biologic treatment with tocilizumab in patients with rheumatoid arthritis in real-life setting: results from TURKBIO registry
    (NATURE PORTFOLIO) Yazici, A; Isik, ÖÖ; Dalkiliç, E; Koca, SS; Pehlivan, Y; Senel, S; Inanc, N; Akar, S; Yilmaz, S; Gündüz, ÖS; Cefle, A; Karakas, ÖF; Onen, F
    Tocilizumab (TCZ) is a recombinant humanized monoclonal antibody that targets the IL-6 receptor. TCZ found to be efficacious and has a good tolerated safety profile in rheumatoid arthritis (RA) patients. The aim of this study was to describe the disease activity and retention rate in Turkish RA patients who were prescribed TCZ as first-line biologic treatment in a real-world setting. Secondary data obtained from adult RA patients' files was used in a multicenter and retrospective context. Clinical Disease Activity Index (CDAI), Disease Activity Score in 28 joints with ESR (DAS28-ESR), and retention rates of TCZ were evaluated at related time points. 130 patients (87.7% female) with a mean age of 53 years (SD; 15.0) were included in the study. Mean RA duration was 14 years and median duration of follow-up was 18.5 months. Number of patients with ongoing TCZ treatment at 6, 12, and 24 months were 121 (93%), 85 (65%), and 46 (35%), respectively. Remission rates at 6, 12, and 24 months per CDAI (<2.8) and DAS28-ESR (<2.6) scores were 61.5, 44.6, 30%, and 54.6, 40.8, 27.7%, respectively. Both CDAI and DAS28-ESR scores significantly improved at 6, 12 and 24 months (p<0.001 for both). At 24 months, 23 patients (17.6%) discontinued TCZ, of whom majority (17/23) were due to unsatisfactory response. Retention rates of TCZ at 6, 12, and 24 months were 93, 84.3, and 72.2%, respectively. In this real-world study, TCZ as a first-line biologic therapy was found to be efficacious and showing high retention rates. These real-world study results are in line with previous randomized studies.
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    The effects of residual affective symptoms on cognitive and social functioning in remitted bipolar patients
    (CUMHURIYET UNIV TIP FAK PSIKIYATRI ANABILIM DALI) Kaya, E; Aydemir, O; Selçuki, D
    Objective: In bipolar disorder, both cognitive and social functioning is impaired during remission. It is not well documented whether residual affective symptoms cause impairment in cognitive and social functions or cognitive impairment per se is the source of psychosocial dysfunction during remission. In this work, the effects of subsyndromal residual affective symptoms on cognitive and social functioning in remitted bipolar patients are studied. Materials and Methods: The study was carried out with 43 patients diagnosed as bipolar I disorder with a remission for at least 6 months. The mean age of the patients was 38.1 +/- 13.5 and 55.8% (n=24) were male. The mean duration of illness was 12.1 +/- 10.2 years and the mean number of previous episodes was 6.6 +/- 6.0. As healthy controls, 22 volunteers without any lifetime psychiatric and medical diagnosis or treatment were invited to the study. In the assessment Hamilton Depression Rating Scale (HAM-D), Young Mania Rating Scale (YMRS), Stroop Test, Auditory Verbal Learning Test (AVLT), increased latency positive-evoked potentials (P300), Global Assessment of Functioning Scale (GAF), and Social Functioning Scale (SFS) were used. In statistical analyses, linear regression analysis was performed. Results: HAM-D scores significantly affected cognitive functions such as P300 amplitude, immediate recall, verbal learning, delayed recall, recognition, retrieval, Stroop effect, and social functions such as social engagement, interpersonal behavior, prosocial activities, recreation, independence-performance and competency and employment. YMRS scores affected only verbal learning. Cognitive functions do not have any effect on mood symptoms or social functions. Discussion and Conclusion: Subsyndromal residual depressive symptoms seem to affect functioning in remitted bipolar patients. In order to improve the functioning of the bipolar patients, it will be helpful to implement strategies for these depressive symptoms. (Anatolian Journal of Psychiatry 2009; 10: 124-130)
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    Predictors of ASDAS-CRP inactive disease in axial spondyloarthritis during treatment with TNF-inhibitors: Data from the EuroSpA collaboration
    (W B SAUNDERS CO-ELSEVIER INC) Ornbjerg, LM; Linde, L; Georgiadis, S; Rasmussen, SH; Lindström, U; Askling, J; Michelsen, B; Di Giuseppe, D; Wallman, JK; Pavelka, K; Závada, J; Nissen, MJ; Jones, GT; Relas, H; Pirilä, L; Tomsic, M; Rotar, Z; Geirsson, AJ; Gudbjornsson, B; Kristianslund, EK; Horst-Bruinsma, IV; Loft, AG; Laas, K; Iannone, F; Corrado, A; Ciurea, A; Santos, MJ; Santos, H; Codreanu, C; Akkoc, N; Gunduz, OS; Glintborg, B; Ostergaard, M; Hetland, ML
    Objectives: In patients with axial spondyloarthritis (axSpA) initiating their first tumor necrosis factor alpha-inhibitor (TNFi), we aimed to identify common baseline predictors of Ankylosing Spondylitis Disease Activity Score (ASDAS-CRP) inactive disease (primary objective) and clinically important improvement (CII) at 6 months, and drug retention at 12-months across 15 European registries. Methods: Baseline demographic and clinical characteristics were collected. Outcomes were investigated per registry and in pooled data using logistic regression analyses on multiply imputed data. Results: The consistency of baseline predictors in individual registries justified pooling the data. In the pooled dataset (n = 21,196), the 6-month rates for ASDAS inactive disease and ASDAS CII were 26% and 51%, and the 12-month drug retention rate 65% in patients with available data (n = 9,845, n = 6,948 and n = 21,196, respectively). Nine common baseline predictors of ASDAS inactive disease, ASDAS CII and 12-month drug retention were identified, and the odds ratios (95%-confidence interval) for ASDAS inactive disease were: age, per year: 0.97 (0.97-0.98), men vs. women: 1.88 (1.60-2.22), current vs. non-smoking: 0.76 (0.63-0.91), HLA-B27 positive vs. negative: 1.51 (1.20-1.91), TNF start year 2015-2018 vs. 2009-2014: 1.24 (1.06-1.45), CRP > 10 vs. <= 10 mg/l: 1.49 (1.25-1.77), one unit increase in health assessment questionnaire (HAQ): 0.77 (0.58-1.03), one-millimeter (mm) increase in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) fatigue and spinal pain: 0.99 (0.99-1.00) and 0.99 (0.99-1.99), respectively Conclusion: Common baseline predictors of treatment response and adherence to TNFi could be identified across data from 15 European registries, indicating that they may be universal across different axSpA populations.