Researcher:
Amuk Williams, Özge Ceren

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Undergraduate Student

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Özge Ceren

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Amuk Williams

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Amuk Williams, Özge Ceren

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2014 - 201912020 - 20226

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    Substance use disorders in patients with Parkinson's disease and adverse hospitalization outcomes: a national inpatient study
    (Cureus Journal of Medical Science, 2021) Kaur, Jaskaranpreet; Sandhu, Ramneek K.; Kubra, Khadija T.; Benitez, Johanna S. Canenguez; Onyeaka, Henry K.; Akter, Sabiha; Amuk Williams, Özge Ceren; Undergraduate Student; School of Medicine; N/A
    Objectives To understand the demographic pattern of substance use disorders (SUD) in Parkinson's disease (PD) inpatients and to evaluate the impact of SUD on hospitalization outcomes including the severity of illness, length of stay (LOS), total charges, and disposition to nursing facilities. Methods We used the nationwide inpatient sample and identified adult patients (age, >= 40 years) with PD as a primary diagnosis and comorbid SUD (N = 959) and grouped by co-diagnosis of alcohol (N = 789), cannabis (N = 46), opioid (N = 30), stimulants (N = 54) and barbiturate (N = 40) use disorders. We used a binomial logistic regression model to evaluate the odds ratio (OR) for major loss of functioning and disposition to nursing facilities in PD inpatients. All regression models were adjusted for demographics, including age, sex, race, and median household income. Results Alcohol, opioid, and stimulant use disorders were prevalent in old-age adults (60-79 years), males, and whites, but cannabis use was prevalent in middle-aged adults (40-59 years), and barbiturate use among older-age (>80 years). The severity of illness is statistically higher in PD inpatients with comorbid opioid and barbiturate use disorders with major loss of body functioning, closely seconded by alcohol and stimulant use disorder cohorts (27.6% and 25.9%, respectively). Disease severity and loss of body functioning increase with advancing age (>80 years adults, OR 5.8, 95%CI 5.32-6.37), and in blacks (OR 1.7, 95%CI 1.56-1.81), and those with opioid use disorder (OR 3.8, 95%CI 1.96-7.35). PD inpatients with barbiturate use disorder had a higher LOS and charges by 17.4 days and $68,922, and six-fold increased likelihood (95%CI 2.33-15.67) for disposition to nursing facilities. Conclusions SUD is prevalent among PD patients and is associated with more severe illnesses with body loss functioning and prolonged care. A multidisciplinary care model including collaborative neuropsychiatric and addiction management is required to manage SUD among PD patients to lessen disease severity, slow down the disease progression and potentially save medical costs.
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    Sleep quality impairments in schizophrenia and bipolar affective disorder patients continue during periods of remission: a case-controlled study
    (Brazilian Assoc Sleep, 2022) Hacımusalar, Yunus; Karaaslan, Özgül; Mısır, Emre; Hacımusalar, Göknur; N/A; Amuk Williams, Özge Ceren; Undergraduate Student; School of Medicine; Koç University Hospital; N/A
    Objective: Bipolar disorder (BD) and schizophrenia are chronic psychiatric disorders in which sleep disorders are commonly seen. In mental disorders, residual symptoms may persist even if symptoms are greatly reduced overall. The aim of this study was to compare the sleep quality of schizophrenia and BD patients in remission with that of healthy controls. Methods: Forty-three patients with schizophrenia, 46 BD patients in remission for at least 3 months, and 51 healthy controls were included the study. The Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Young Mania Rating Scale (YMRS) and Pittsburgh Sleep Quality Index (PSQI) were administered to all participants and the Positive and Negative Syndrome Scale (PANSS) was administered to patients with schizophrenia. Results: Poor sleep quality was more frequent in the patient groups than the control group (p=0.009). PSQI score was positively correlated with duration of disease (r=0.236; p=0.026), number of cigarettes smoked per day (r=0.430; p<0.001), body mass index (r=0.189; p=0.025), and negatively correlated with duration of remission (r=-0.224; p=0.0359). Conclusion: Schizophrenia and BD patients in remission had worse sleep quality than a control group. Sleep quality was worst in the patients with schizophrenia. The severity of sleep disorder symptoms was positively associated with disease duration and negatively associated with duration of remission. Schizophrenia and BD patients should be carefully evaluated for symptoms of sleep disorders even when they are in clinical remission and should be offered additional treatment for sleep disorder symptoms when necessary.
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    Motor afferents from the cerebellum, zona incerta and substantia nigra to the mediodorsal thalamic nucleus in the rat
    (Imr Press, 2014) N/A; N/A; N/A; N/A; Çavdar, Safiye; Özgür, Merve; Uysal, Sanem Pınar; Amuk Williams, Özge Ceren; Faculty Member; PhD Student; Undergraduate Student; Undergraduate Student; School of Medicine; Graduate School of Health Sciences; School of Medicine; School of Medicine; 1995; 197462; N/A; /A
    The mediodorsal (MD) thalamic nucleus provides information from subcortical structures to the prefrontal cortex. The human MD thalamic nucleus has been implicated in a great variety of different clinical conditions and normal functions ranging from schizophrenia, ParkinsÖnişm and epilepsy to many cognitive functions. In the rat the MD thalamic nucleus is divided into three cytoarchitectonic sectors whereas in the primates it is divided into two; medial one-third (magnocellular) and lateral two-thirds further the lateral sector is divided into pars parvocellularis pars multiformis, pars fasciculosa and pars caudalis. In this study we used a retrograde tracer, fluoro-gold (FG) to evaluate some of the afferents reaching the lateral sector of the MD (MDl) thalamic nucleus. The results of the present study have shown that MDl receives afferent connections from the lateral cerebellar nucleus (dentate nucleus), substantia nigra pars reticulata (SNR) and zona incerta (ZI). Subsequent to FG injections into the MDl, labeled cells were observed mainly bilaterally but were sparser on the contralateral side than ipsilaterally from each of the three structures listed. All three afferents showed a topographical organization. The labeled neurons were localized at the dorsomedial aspect of the lateral cerebellar nucleus, the dorsoventral aspect of the SNR and in the dorsal sector of the ZI. The lateral cerebellar nucleus reached the MDl via the superior cerebellar peduncle. No other deep cerebellar nuclei showed labeled cells. There were no labeled cells in the substantia nigra pars compacta (SNC). Although the three regions identified here are recognized as having motor functions, the connections to MD suggest that their outputs also play a role in cognitive or other higher cortical functions.
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    Do demographics and comorbidities act as predictors of co-diagnosis of attentiondeficit/hyperactivity disorder in autism spectrum disorder?
    (Cureus Inc, 2020) Ashraf, Sahar; Eskander, Noha; Patel, Rikinkumar S.; N/A; Amuk Williams, Özge Ceren; Undergraduate Student; School of Medicine; Koç University Hospital; N/A
    Objective The study aims to determine the demographic predictors of attention-deficit/hyperactivity disorder (ADHD) in hospitalized children with autism spectrum disorder (ASD) and the impact of comorbidities on the length of stay (LOS). Methods A retrospective study was performed using a nationwide inpatient sample from US hospitals. All patients were < 18 years in age with a primary diagnosis of ASD (n = 3,095) and grouped by co-diagnosis of ADHD based on the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnosis codes. Logistic regression was used to calculate the odds ratio (OR) and linear regression for estimated LOS. Results Male patients had a higher odds of comorbid ADHD (OR: 2.2). Age and race were not significant predictors of ADHD though the condition was found to be prevalent in adolescents and Caucasians. These children were mainly from the South (30.8%) and the Midwest (29.9%) regions of the US. Psychosis was seen in 37.3% of patients with ADHD and was more likely to be comorbid psychosis (OR: 1.8). Depression and ADHD increased the LOS in hospitals for ASD by 2.1 days and 0.9 days, respectively. Conclusion Our study led us to determine the demographic predictors of comorbid ADHD in patients with autism, and we believe that our findings can help to better serve these patients and their families. Comorbid ADHD and depression can prolong the length of hospitalization and they necessitate the need for acute inpatient care in such patients.
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    Alcohol use disorder increases risk of traumatic brain injury-related hospitalization: insights from 3.8 million children and adolescent inpatients
    (Cureus Inc, 2020) Eskander, Noha; Prabhudesai, Shruti; Imran, Hira; Patel, Rikinkumar S.; N/A; Amuk Williams, Özge Ceren; Undergraduate Student; N/A; N/A
    Objectives We conducted a cross-sectional study to identify the demographic predictors of traumatic brain injury (TBI), and the risk of association of psychiatric comorbidities including alcohol use disorder (AUD) and TBI-related hospitalizations in the children and adolescent population. Methods We included 3,825,523 children and adolescent inpatients (age 8-18 years) using the nationwide inpatient sample (NIS) database (2010-2014), and 61,948 inpatients had a primary diagnosis of TBI. These inpatients were grouped by comorbid AUD (N = 2,644). Multivariable logistic regression model adjusted for demographics, and psychiatric comorbidities including other substance use disorders (SUDs) was used to evaluate the odds ratio (OR) of AUD as a risk factor for TBI-related hospitalization. Results The majority of the TBI inpatients were adolescents (12-18 years, 82.2%), males (71.2%), and whites (59.2%). Males had three times higher odds (95% CI 3.14-3.26) for TBI-related hospitalization compared to females. Among psychiatric comorbidities, mood (4.1%) and anxiety (2.2%) disorders were prevalent in TBI inpatients, and were not associated with increased odds for TBI-related hospitalization. Among SUD, alcohol and tobacco use (4.4% each), and cannabis use (3.5%) were prevalent, and among all substances, AUD was associated with higher odds (OR 3.5, 95% CI 3.35-3.67) of TBI-related hospitalization. These patients with TBI and comorbid AUD also had higher odds for abusing stimulants (OR 5.11, 95% CI 3.85-6.77), cannabis (OR 4.69, 95% CI 4.12-5.34), and tobacco (OR 3.77, 95% CI 3.34-4.27). Conclusion AUD is an independent risk factor for TBI-related hospitalization with an increased risk of 50% in the children and adolescent population compared to non-alcohol users. TBI inpatients with AUD are prevalent in white, and male adolescents. These at-risk populations are also at higher risk of comorbid mood disorders and increased substance use including stimulants, cannabis, and tobacco.
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    Comorbid anxiety and suicidal behaviors in American adolescents with major depression
    (Cureus Journal of Medical Science, 2020) Mathialagan, Keerthika; Eskander, Noha; Patel, Rikinkumar S.; Amuk Williams, Özge Ceren; Undergraduate Student; School of Medicine; N/A
    Objective The aim of this study was to evaluate the odds of association between suicidal behaviors and comorbid anxiety disorders in adolescents with major depressive disorder (MDD). Methods We included 122,020 adolescent inpatients with MDD from the Nationwide Inpatient Sample (NIS) and further grouped them by co-diagnosis of anxiety disorders. Logistic regression analysis was used to evaluate the odds ratio (OR) of suicidal behaviors due to comorbid anxiety disorders. Results Out of total MDD inpatients, 45.8% had comorbid anxiety disorders. Around 53.5% MDD inpatients with anxiety disorders had suicidal behaviors, which were significantly higher than seen in 52.6% non-anxiety cohort (P = 0.002). Comorbid anxiety disorders had a minimally positive association with suicidal behaviors and were not statistically significant (OR: 1.01; P = 0.710) after controlling the logistic regression analysis for demographic confounders and psychiatric comorbidities. MDD inpatients with comorbid psychotic disorders were positively associated (OR: 1.16; P = 0.007) with suicidal behaviors. Conclusions MDD with comorbid anxiety had a statistically non-significant association with suicidal behaviors in adolescents. Depression has a direct and independent effect on adolescent suicidal behaviors, whereas anxiety has a direct effect only on perpetuating depression. Early diagnosis and management of comorbid anxiety and psychosis with MDD reduce functional impairment and suicide risk in at-risk populations.
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    Comorbid anxiety increases suicidal risk in bipolar depression: analysis of 9720 adolescent inpatients
    (Multidisciplinary Digital Publishing Institute (MDPI), 2020) Patel, Rikinkumar S.; Amuk Williams, Özge Ceren; School of Medicine
    Objective: to evaluate the risk of association between suicidal behaviors and comorbid anxiety disorders in adolescents with bipolar depression. Methods: we conducted a cross-sectional study using the nationwide inpatient sample (NIS) from the United States. This study included 9720 adolescent inpatients with bipolar depression and further grouped by co-diagnosis of anxiety disorders. Logistic regression analysis was used to evaluate the odds ratio (OR) of suicidal behaviors due to comorbid anxiety after controlling demographic confounders and psychiatric comorbidities. Results: out of total inpatients, 34.8% (n= 3385) had comorbid anxiety disorders with a predominance in females (70.3%) and White patients (67.7%). About 54.1% of inpatients with comorbid anxiety had suicidal behaviors versus 44.6% in the non-anxiety cohort (p< 0.001). Comorbid anxiety disorders were associated with 1.35 times higher odds (95% CI 1.23-1.47,p< 0.001) for suicidal behaviors. Conclusion: suicidal behaviors are significantly prevalent in bipolar depression adolescents with comorbid anxiety disorders. Anxiety disorders are an independent risk factor in bipolar depression that increase the risk of suicidal behaviors by 35%. This necessitates careful assessment and management of comorbid anxiety disorders in bipolar youth to mitigate suicidality.