Pregabalin reduces central neuronal excitability and has gamma-aminobutyric acid-mimetic features, which was demonstrated in rats. Pregabalin is indicated for the treatment of neuropathic pain, post-herpetic neuralgia, fibromyalgia and partial seizures. However, pregabalin is widely used for off-label conditions. Euphoria is a frequent side effect of pregabalin and several cases of overdose from recreational use have been reported until recently. Our aim is to present a case of a patient with myoclonus after high dose nasal pregabalin misuse. A 23-year-old female patient presented to the emergency department with unconsciousness and involuntary movements in her arms. She used, 10–15 numbers of 300 mg pregabalin capsules by nasal inhalation for recreational purpose for the first time. Her vital signs were within normal limits. The patient's serum ethanol, drug and substance levels were negative. During the examination, myoclonus with 2–3 beats was occasionally observed in the upper extremities. Emergency brain computed tomography was normal. During the electroencephalography (EEG monitorization, one generalized spikewave activity was observed for a second. We started 800 mg valproic acid i.v. therapy and prescribed valproic acid 500 mg/day p.o. at discharge. One week after discharge, she had no myoclonic jerks even though she did not use the recommended antiepileptic drug. Control EEG was within normal limits. Pregabalin overdose was suggested to be relatively safe but myoclonic seizures should be taken into consideration as a side effect.

Aim: Traumatic life events such as earthquake are frequently encountered problems both in our country and all over the world. The aim of this study was to determine sleep quality, trauma level and related factors and to evaluate the effects of gender, damage status and losses in adults who were admitted to the psychiatry outpatient clinic among individuals who were placed in Kırıkkale University student dormitories immediately after the 6 February 2023 earthquakes that affected a wide geography in our country. Methods: 64 volunteers were included in the study between March 2023 and June 2023. After the participants' complaints and sociodemographic characteristics were questioned, the Pittsburgh Sleep Quality Index (PSQI) and the Scale That Determines the Level of the Trauma after the Earthquake (PETLDS) were applied to the participants to determine their sleep quality and trauma levels after the earthquake. Results: The mean age of the participants was 45.5±15.5, and 75.0% of them were women. Fear/anxiety and insomnia were the most frequently reported complaints by the participants. The mean of the participants' PSQI scores was 10.5±4.4, and 43 participants (79.6%) had poor sleep quality in the last month. The mean score of the participants' PETLDS was determined as 76.6±17.9. When the subscales were examined, it was determined that the emotional limitation and cognitive restructuring scores were higher than the behavioral, affective and sleep problems. When the participants were compared in terms of damage in their homes, it was found that the participants with moderately or more damaged houses had statistically higher emotional, cognitive restructuring and sleep problems and total trauma scores compared to the participants with a solid or slightly damaged house (respectively; p=.017, p=.023, p=.010, p=.040). Individuals with moderately or more damaged houses had higher PSQI scores but this difference did not reach statistical significance (p=.061). Conclusion: The earthquakes that occurred in our country on and after 6 February 2023 affected a large area and resulted in millions of people being directly or indirectly affected. To minimize the physical and psychological damage that earthquakes may cause, post-disaster management should be carried out well, and it should be noted that it is a priority to support earthquake victims psychologically as well as their social and medical needs.

Objective: The literature concerning the association between coronary slow flow (CSF) and anxiety and depression is controversial. Furthermore; there is no existing data in the literature on the potential association between CSF and adverse childhood experiences or alexithymia. Methods: The participants underwent coronary angiography through femoral access. Coronary artery blood flow rate was evaluated quantitatively for each coronary artery according to the Thrombolysis in Myocardial Infarction frame count (TFC) method. CSF was diagnosed as a corrected TFC value >27 in at least one coronary artery during the imaging. Symptoms of anxiety and depression were assessed through the Hospital Anxiety and Depression Scale (HADS). Alexithymia and ACE were evaluated by the Twenty-item Toronto Alexithymia Scale (TAS-20) and the Childhood Trauma Questionnaire (CTQ). Results: The study participants were categorized into two groups: normal coronary flow (n = 58) and CSF (n = 18). Total HADS score; HADS anxiety subscale (HADS-A) score; and HADS depression subscale (HADS-D) score were determined as significant factors associated with CSF in univariate logistic regression analysis. However; the TAS-20 and CTQ scores showed no significant association with CSF. Multivariate regression analysis performed in separate models demonstrated that total HADS score (OR: 1.27; 95 CI%: 1.08–1.50; p = 0.003); HADS-A score (OR: 1.25; 95 CI%: 1.03–1.51; p = 0.019); and HADS-D score (OR: 1.36; 95 CI%: 1.06–1.74; p = 0.014) were independently associated with CSF in multivariate logistic regression analysis. Conclusions: Neither alexithymia nor ACE was associated with CSF. On the other hand; measures of both anxiety and depression assessed through HADS were independently associated with CSF. Future studies should address the major limitations of this study; such as the limited sample size; lack of structured diagnostic interview by a psychiatrist; and the lack of establishment of causality

Objective: The aim of this study was to investigate admissions to a psychiatry outpatient clinic in an urban area through one year period and analyze sociodemographic characteristics, diagnosis, and treatment protocols of individual patients with an emphasis on age and gender. Material and Method: Patients who applied to University of Health Sciences, Ankara Numune, Education and Research Hospital Kolej Psychiatry outpatient clinic between February 2016 and February 2017 were included in the study. The patient files were retrospectively reviewed in terms of sociodemographic characteristics, diagnoses, treatment protocols and the number of admissions within one year. Results: Retrospective evaluation of hospital records yielded 1247 patients. Among these patients, 66.5% were female and 85.2% were under 65 years old. The most common diagnoses were depressive and anxiety disorders with a percentage of 42% and 40.3%, respectively. Anxiety disorders (66.4%, 33.6%, p<0.001, respectively), depressive disorders (72.7%, 27.3%, p<0.001, respectively) and somatic symptom disorders (90.9%, 9.1%, p=0.007, respectively) were significantly more frequent in females compared to male gender. On the other hand, all psychiatric diagnoses except normal psychiatric examination were significantly higher in patients <65 years old compared to patients ≥65 years of age. There was a positive and moderate correlation between age and number of comorbid conditions (r=0.57, p<0.001) and positive and weak correlation between age and number of psychiatric medications (r=0.07, p=0.006). However, there was no correlation between age and number of control visits. Conclusion: Depressive and anxiety disorders were the most common diagnoses both in adult and elderly patient populations among patients who admitted to a district outpatient clinic of a tertiary hospital within one year period. Female gender admissions were more prevalent than males.

There is a close linkage between anxiety disorders (ADs), and development of cardiovascular disease (CVD) and atrial fibrillation (AF). We aimed to investigate left atrial function index (LAFI) and its components, LA mechanical functions and atrial conduction times in AD patients and age- and gender-matched control group patients for the first time in the literature. A total of 48 AD patients and 33 healthy subjects were enrolled to the study prospectively. Echocardiographic parameters including two-dimensional conventional echocardiography, diastolic functions, LA mechanical functions, LAFI, atrial conduction times and atrial electromechanical delay (AEMD) were calculated. The velocity-time integral of the LV outflow tract (LVOT-VTI), LAFI and LA conduit volume were significantly lower in AD patients. Atrial electromechanical coupling as established from lateral mitral annulus (PA lateral) was significantly higher in AD group than control group. Inter-AEMD and left intra-AEMD were also higher in AD group compared to control group. Age, gender, body surface area (BSA), conduit volume, LVOT-VTI and LAFI were significant factors associated with AD in univariate analysis. However, only BSA and LVOT-VTI (Odds ratio [OR]: 0.79, 95 CI%: 0.66-0.95, p = 0.013) were independently associated with AD in multivariate analysis. Age, gender, conduit volume and LAFI (OR: 0.25, 95 CI%: 0.03-2.12, p = 0.204) were not found to be independent associates of AD. LAFI is impaired in patients suffering from AD compared to their age- and gender-matched counterparts but this impairment originates from lower levels of LVOT-VTI calculations in AD patients. Thus, LVOT-VTI, but not LAFI, is independently associated with AD.