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COVID-19 related Delusional Beliefs: A Case Report
- S. Akyildirim Cor, B. D. Akcay
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S809-S810
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Introduction
A delusion is a fixed false belief based on an inaccurate interpretation of an external reality despite evidence to the contrary. The diagnosis of a delusional disorder is made when a person has one or more non-bizarre (situations that are not real but also not impossible) delusional thoughts for one month or more that cannot be explained by any other condition. In patients with delusional disorder, delusions(s) do not impact the functionality and the patient’s behavior is not overtly bizarre. Although delusional core themes tend to be the same throughout different epochs (i.e., persecution, grandiosity, guilt, religion, hypochondria, love, or jealous), clinicians commonly notice how delusions tend to rapidly incorporate popular hot topical issues. Hence, delusions are dynamic and often represent a combination of psychopathology and external events.
ObjectivesThe COVID-19 outbreak has affected millions of people globally and it also has a huge psychological impact. The objective of this case report is to outline the possible effect of the COVID-19 pandemic to delusional disorder in patients with healthy person.
MethodsThe 40-year-old gentleman, a drum major (field commander), married, living with his wife and daughter (4,5 years old). He’s current complaints started when he did not want to have the Covid vaccine in April 2021 and therefore was exposed to mobbing at work. It is understood that the patient had irrevocable ideas about vaccine and PCR testing (radioactive lights were coming out from the PCR rod in a video he watched). For this reason, it is understood during the clinical interview that the patient was exposed to social restrictions at work and in his social life (he could not travel by public transport, plane, bus, and enter social facilities because he did not have a vaccination card or did not have a PCR test).He was admitted to our ward for the purpose of arranging his diagnosis and treatment.
ResultsOn our ward, the patient showed poor insight with persistence of delusions. The impression was delusinal disorder. He was treated with olanzapine up to 5 mg/day and sertraline up to 100 mg/day, with a progressive resolution of symptoms.
ConclusionsThere are other case reports on COVID-19 delusional themes in patients with schizophrenia and patients with no history of mental illness, which means that this phenomenon is not exclusive to affective disorders. In this case, different from the literature, the patient has never had covid. An area of clinical concern is the potential of the pandemic’s psychological context to trigger psychotic disorders and influence their symptomatology. A review of contemporary epidemics and pandemics psychosis research found no evidence of changes in the form and content of psychotic symptoms. Further research should examine those biopsychosocial COVID-related factors that predispose to, precipitate, and perpetuate psychosis.
Disclosure of InterestNone Declared
P-961 - Changes in the Sleep Structure of the Patients Diagnosed With Post-traumatic Stress Disorder
- B. Akcay, F. Ozgen, S. Yetkin, N. Lapsekili
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- Journal:
- European Psychiatry / Volume 27 / Issue S1 / 2012
- Published online by Cambridge University Press:
- 15 April 2020, p. 1
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Introduction
Sleep disturbance is a common complaint among patients diagnosed with post-traumatic stres disorder (PTSD). Polysomnography is one of objective methods used to better understand the pathophysiology of PTSD. But consistent results of polysomnography have not been obtained so far.
ObjectiveThe aim of this study is to investigate sleep structure and the relationship between sleep variables and clinical symptoms in adult male PTSD patients with combat trauma, with or without comorbid psychiatric disorder and without any medication.
Methodology30 PTSD patients and 19 healthy subjects exhibit similar characteristics in terms of age and sex were included in the study. Two consecutive overnight polysomnographic sleep study were performed to investigate sleep patterns.
ResultsIn this study we found that compared with normal controls, PTSD patients exhibited difficulty in starting sleep, reduced sleep efficiency, decreased total sleep time, prolonged sleep latency, increased Stage-1 sleep, increased REM density and REM sleep, increased phasic EMG activity percentage. Also, comorbid psychiatric disorders accompanying PTSD affected the structure of sleep and there was a significant relationships between symptom severity and sleep variables.
ConclusionAlthouh the relationship between symptom severity and sleep parameters was found significant, there was no relationship between the changes of sleep parameters and shape of the traumatic event, elapsed time after injury and deterioration in the integrity of the body. In the PTSD patients we observed disturbed sleep patterns (Sleep continuity, sleep structure, REM sleep) which support the finding that these patients are in an arousal state even at night.
Geochemistry of a high-T hydrothermal dolostone from the Emirli (Ödemiş, western Turkey) Sb-Au deposit
- M. Akçay, H. M. Özkan, B. Spiro, R. Wilson, P. W. O. Hoskin
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- Journal:
- Mineralogical Magazine / Volume 67 / Issue 4 / August 2003
- Published online by Cambridge University Press:
- 05 July 2018, pp. 671-688
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A dolostone layer is found in spatial association with the Emirli epithermal Sb-Au deposit in western Turkey. It occurs within an argillic alteration zone adjacent to the major Emirli fault zone, which is the controlling structure for the deposit, and is composed of large closely packed subhedral to anhedral planar and nonplanar dolomites. Pyrite is the only accessory mineral in the layer and occurs as disseminations and veinlets up to 100 μm wide. Dolomite crystals are petrographically homogeneous and have consistent deep-red cathodoluminescence (CL) colour with no zoning which implies single-stage dolomitization of a calcitic precursor which is partly preserved as remnant patches of orange-coloured CL zones. Some crystal boundaries have dark (or no) CL colour. Electron microprobe line-scan analyses across these regions indicate intense enrichment of Fe and Mg depletion, revealing late-stage Fe-metasomatism (ankeritization) especially prevalent near pyrite veinlets and disseminations.
Dolomite crystals are composed of 52.4–55.0 mol.% CaCO3, 29.9 –41.2 mol.% MgCO3, 1.8 – 14.4 mol.% FeCO3 and 0.75 –3.2 mol.% MnCO3 indicating ferroan dolomite. The relationship between Ca and Mg is not stoichiometric due to substitution of Mg2+ by Fe2+ after dolomitization, as demonstrated by a strong negative correlation between Fe and Mg. Whole-rock Fe contents of the dolostone layer increases toward the Emirli fault zone.
The δ13C(PDB) compositions of the Emirli dolomite, calcitic marbles, and graphite-schists are in the ranges of –1.6 to 0.8‰, 1.5 to 1.5‰ and –6.6 to –23.5%, respectively, indicating that dolomite was formed due to interaction of light-carbon-enriched fluids with calcitic marbles; light-carbon may have been derived from decarboxylation of the graphitic schist layers. δ18O(PDB) values of dolomite and marble range –15.2 to – 11.2‰ and –2.4 to – 3.5‰, respectively. This large isotopic difference between dolomite and marble was probably inherited from oxygen isotope exchange between the dolomitizing fluid and the precursor calcites, as well as other minerals enriched in light-oxygen.
Fluid inclusions in dolomite are two-phase, and homogenize into liquid within the temperature interval 242 – 362ºC with a mode of 290ºC, and have salinities of 1 – 3 wt.% NaCl equiv. Using this modal temperature, the average δ18O(PDB) composition of water in isotopic equilibrium with the Emirli dolostone was estimated to be –19.4±2.1‰, which is interpreted as an indication of modified surface-waters; this interpretation is also supported by low fluid salinity and Na and Sr contents. These fluids migrated along graben-related faults, penetrating deeper levels where they were transformed into hydrothermal fluids due to the high heat-flow of the Küçük Menderes graben system, and flowed-up mainly through the Emirli and Haliköy faults that control mineralization in local deposits of Sb-Au and Hg, respectively. Due to interaction with chlorite-bearing graphite-schists, the fluid may have dissolved Mg2+ from chlorite and been enriched in isotopically-light carbon due to decarboxylation of graphite. Dolomitization occurred as a result of the interaction of these fluids with a calcitic marble band adjacent to the Emirli fault zone. Subsequent introduction of Fe2+ caused ankeritization along dolomite crystal boundaries during first-stage Sb-Au mineralization.