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Introduction: In many studies that are aimed to determine the psychological profile of patients admitted to the emergency unit with non-cardiac angina (NCA), it was indicated that psychiatric problems, less effective problem-solving, and alexithymia are more common in NCA compared with acute coronary syndrome (ACS) patients. In this study, aiming to find predictive psychological clinical features, we compared the temperament, anxiety, and depression scores of patients with NCA and ACS. Methods: Sociodemographic variables of 63 patients (n=41 NCA, n=22 ACS) who were admitted to the emergency unit with chest pain were recorded. TEMPS-A scale was used for defining temperamental features, and Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety and depression levels of patients in both groups. Sociodemographic variables and TEMPS-A and HADS scores were compared with x2 and independent-groups t-test between the NCA and ACS groups. Results: The NCA and ACS groups were similar in terms of sociodemographic variables. There was no statistical difference between groups in HDS (p=0.12) and HAS (p=0.39) scores and TEMPS-A scale depressive (p=0.41), cyclothymic (p=0.08), hyperthymic (p=0.06), and anxious (p=0.29) temperament scores. But, irritable temperament scores were significantly higher in the NCS group (p=0.04). Conclusion: We believe that our findings will provide a basis for further studies in the diagnosis and treatment of NCA by contributing to the definition of NCA patients' psychological profiles. [ABSTRACT FROM AUTHOR]

Introduction: Ankylosing spondylitis (AS), which has an unknown etiology, inflammatory disorder, characterized by inflammation of the spinal joints and adjacent structures. It has a negatif effect on all aspects of a patients's life: Physcally, psychologically and socially. The purpose of this study was to determine the effect of AS on self-esteem and alexithymia. Method: In this study, 50 patients from the department of physical therapy and rehabilitation with the diaognosis of AS who were under traetment and follow-up and 50 healty volunteers who matched for age and gender were taken. Toronto Alexithymia Scale (TAS), Beck Depression Inventory (BDI), Rosenberg Self-Esteem Scale (RSES), Beck Anxiety Inventory (BAI), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were performed to both patients and control group. Results: Compared to the control group, the anxiety and depression scores were higher in the patient group and the alexithymic characteristics were significantly higher, self-esteem scores were significantly lower in the patient group (p<0.05). Conclusion: Like all the other inflammatory chronic diseases, depression and anxiety are commonly seen in AS patients. Alextthymai and self-esteem of these patients should be considered carefully. More studies are needed on this regard. [ABSTRACT FROM AUTHOR]

Introduction: In this study, we aimed to develop two reliable and valid assessment instruments for investigating the level of difficulties mental health workers experience while working with patients with personality disorders and the attitudes they develop tt the patients. Methods: The research was carried out based on the general screening model. The study sample consisted of 332 mental health workers in several mental health clinics of Turkey, with a certain amount of experience in working with personality disorders, who were selected with a random assignment method. In order to collect data, the Personal Information Questionnaire, Difficulties of Working with Patients with Personality Disorders (KBHİÇZÖ), and Attitudes Towards Patients with Personality Disorders Scales (KBHİTÖ), which are being examined for reliability and validity, were applied. To determine construct validity, the Adjective Check List, Maslach Burnout Inventory, and State and Trait Anxiety Inventory were used. Explanatory factor analysis was used for investigating the structural validity, and Cronbach alpha, Spearman-Brown, Guttman Split-Half reliability analyses were utilized to examine the reliability. Also, item reliability and validity computations were carried out by investigating the corrected item-total correlations and discriminative indexes of the items in the scales. Results: For the KBHİÇZÖ KMO test, the value was 0.946; also, a significant difference was found for the Bartlett sphericity test (p<0.001). The computed test-retest coefficient reliability was 0.702; the Cronbach alpha value of the total test score was 0.952. For KBHİTÖ KMO, the value was 0.925; a significant difference was found in Bartlett sphericity test (p< 0.001); the computed reliability coefficient based on continuity was 0.806; and the Cronbach alpha value of the total test score was 0.913. Analyses on both scales were based on total scores. Discussion: It was found that KBHİÇZÖ and KBHİTÖ have good psychometric properties, measuring the structure that is being investigated, are compatible with other scales, have high levels of internal reliability between their items, and are consistent across time. Therefore, it was concluded that both scales are valid and reliable instruments. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to evaluate and describe the three-stage triage method used in a child and adolescent psychiatry outpatient clinic. Method: The study investigated the new allocation process of 1482 children and adolescents who were assessed using this triage system for the duration of one year, in the year 2005. Data of 1423 children and adolescents who presented in 2003 regarding the waiting time for the first appointment and the rate of non-attendance at the first appointment were used for the comparison. In triage system, new patients presenting to the outpatient clinic in the morning four days a week were assessed by a three-stage procedure: An initial Strengths and Difficulties Questionnaire screening and a structured interview administered by an intern was then followed by a clinical interview. Results: Of the 1482 children and adolescents who presented to the outpatient clinic during the study period, 1291 were given further appointments. Among patients who presented in 2005, the 207 non-attendant patients were significantly more likely to have longer waiting times than the 1084 attendant patients. When compared to year 2003, it was found thatthere was a significant decrease in the mean waiting time for the first appointment and the rate of non-attendance at the first appointment among patients who presented in 2005. Conclusion: The triage procedure used in this study may constitute a model for developing countries with limited health care resources. [ABSTRACT FROM AUTHOR]

Introduction: We aimed to investigate the effects of antipsychotics on prolactin levels in patients diagnosed with schizophrenia and the effects of hyperprolactinemia on bone mineral density (BMD) in patients on long-term antipsychotics. Method: In this study, we included eighty consecutive patients who were diagnosed with schizophrenia according to DSM-IV, had been using the same antipsychotic for the last ten months, and fulfilled the inclusion criteria. Data on sociodemographic characteristics of the patients were collected through an information sheet. The Scale for the Assessment of Negative Symptoms (SANS) and the Scale for the Assessment of Positive Symptoms (SAPS) were used to rate positive and negative symptoms of the patients. In addition, their body mass indices (BMI) were calculated. Prolactin levels were measured through luminescence immune assay and BMD measurements were made at lumbar and femoral sites using dual-energy x-ray absorbtiometry. Haloperidol (n=20) and risperidone (n=20) were assigned to prolactin-raising antipsychotic group, and olanzapine (n=20) and quetiapine (n=20) were assigned to prolactin-sparing antipsychotic group for this study. The effects of antipsychotics on BMD were compared among these groups. Results: Hyperprolactinemia was determined in 60% of haloperidol using patients, 90% of risperidone using patients, 25% of olanzapine using patients and 10% of quetiapine using patients. Mean prolactin levels were found to be significantly higher in prolactin-raising antipsychotic using group (p<0.001). There were no statistically significant differences in BMD values between the two groups, for the sites where the measurement was done. Lumbar spine and femoral neck T-scores and Z-scores in the prolactin-raising group significantly negatively correlated with the treatment durations and chlorpromazine- equivalent doses (p<0.05). BMI and BMD values of both groups also displayed statistically significant positive correlations (p<0.05). Conc I usion: The statistically significant differences in mean prolactin levels and numbers of patients with hyperprolactinemia between the treatment groups support the validity of classifying the antipsychotics as "prolactin- raising" and prolactin-sparing". The relationship of BMD with the treatment duration and doses in the prolactin-raising antipsychotic using group was deemed to be important, since it indicated that a decrease in BMD was to be expected in long-term antipsychotic treatment. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of the present research is to compare the Turkish translations of school and home versions of the Scales for Diagnosing Attention-Deficit/Hyperactivity Disorder (SCALES) developed by Ryser and McConnell with respect to age and gender and to examine the correlation between the two scales. Method: The research was conducted with 102 teachers and parents of 891 children aged between 5.0 and 14.11 years. 656 scale forms of parents returned to us were included in the study. The teachers filled in teacher information form, child information form, SCALES-School Rating Scale and the Turkish version of Conners' Teacher Rating Scale. The parents filled in family information form, child information form and SCALES- Home Rating Scale and the Turkish version of the Conners' Home Rating Scale. Results: When SCALES-Home Rating Scale and SCALES-School Rating Scale scores of each age group were compared using t-test, it was observed that the difference in all sub-scale scores in the 5-9 age group was significant and it was also observed that in the 10-13 and 13+ age groups, the difference was significant only in the hyperactivity field. The correlation between SCALES-School Rating Scale and SCALES-Home Rating Scale was investigated. The correlation between sub-scales measuring the same abilities was found to be between 0.1 and 0.26. Conclusion: We assume that the Turkish version of the SCALES is a valid and reliable instrument for diagnosing ADHD. Since SCALES-Home Rating Scale scores were higher than SCALES-School Rating Scale scores and the correlation between the two scales was low, we assume that the objectivity of parents' ratings was limited.. Future validity studies on diagnosed children are needed. [ABSTRACT FROM AUTHOR]

Introduction: Neurodegeneration is a process that is characterized by the loss of neuronal structure and function and eventually ends with neuronal death. An elevated level of inducible nitric oxide synthase (iNOS) is suggested to accompany this process by inducing oxidative and nitrosative damage. Vitamin D is reported to protect glial cells against neurotoxicity via suppressing iNOS synthesis. Though there was no data about whether iNOS is regulated by vitamin D in hippocampal neurons. In this study our aim was to determine any alteration in iNOS expression of hippocampal neurons in response to vitamin D treatment. Method: Twenty four and 48 hours of vitamin D treatments were performed on primary hippocampal neuron cultures that were prepared from Sprague dawley rat embryos (E18). The alterations in the iNOS mRNA expression were determined with quantative real time polymerase chain reaction (qRT-PCR). The cytotoxicity levels of each group were investigated by the measurement of lactate dehydrogenase (LDH) that is released to culture medium. Results: No difference was observed between groups in 24 hours of treatment regarding the iNOS expression. Though the iNOS mRNA level of vitamin D treated group was significantly lower than that of control group on the 48th hours of treatment (p<0.001). Vitamin D treatment also attenuated the LDH release which is an indicator of cytotoxicity (p<0.001). Conclusion: Our results indicated that vitamin D has the potential to prevent oxidative damage by suppressing iNOS expression. [ABSTRACT FROM AUTHOR]

Introduction: Unipolar depression is an important psychiatric disorder that leads to an increased risk of suicide. However, not all depression patients attempt suicide. This reflects the presence of other factors that may be related to suicide other than the sole presence of psychopathology. Drawing upon the clinical evidence linking childhood abuse and neglect experiences with suicide; this study aimed at investigating the relationship of childhood abuse and neglect experiences with suicide attempts in patients with unipolar depression. Method: One hundred six unipolar depressed patients between the ages of 18 and 65 were included in the study. Patients with comorbid psychiatric disorders, neurological disorders, alcohol-substance abuse problems, and a Beck Depression Inventory (BDI) score of <17 were excluded from the study. The BDI, Childhood Trauma Questionnaire (CTQ-28), State-Trait Anger Expression Inventory (STAXI), and the Suicide Behavior Questionnaire (SBQ) were administered to all patients. Suicidal and non-suicidal cases were determined according to clinic interviews and the patients' responses in the SBQ. Results: Sixty-four patients have previously attempted suicide. Although there was no significant difference between unipolar depression patients with a history of suicide attempts and patients with no history of suicide attempts in terms of average age, education and marital status, however, female/male ratio in the former group was determined to be significantly higher. BDI, STAXI continuous anger and outward anger average scores, and average CTQ-28 emotional abuse, physical abuse and total scores were significantly higher in the group with a history of suicide attempts. The predictors of suicide attempts were higher BDI and CTQ-28 physical abuse scores and female gender. The predictors for average SBQ scores were determined as higher BDI, CTQ-28 sexual abuse, and STAXI outward anger and continuous anger scores. Conclusion: Childhood physical and sexual abuse experiences are important factors in evaluating the presence of suicide attempts and risk of suicide in patients with unipolar depression. Careful questioning of traumatic childhood experiences during psychiatric examinations and monitoring of depression patients is crucial in determining treatment protocols and preventing suicide attempts. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to determine coping with stress and body image in patients with ankylosing spondylitis (AS) and to investigate the correlation between these two characteristics together and also between them and disease activity/functional capacity. Method: Fourty healthy controls and 40 patients with AS who were diagnosed on the basis of Modified New York Criteria were included in the study. The exclusion criteria were another medical disease or comorbid psychiatric disorder. All participants were administered the Coping Orientations to Problems Experienced (COPE) questionnaire in order to evaluate attitudes to coping with stress and the Multidimensional Body- Self Relations Questionnaire (MBSRQ) to evaluate body image. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) were used to evaluate AS patients' disease activities and functional capacities. Results: There was no difference between the two groups in terms of COPE scores. The MBSRQ 'health evaluation' subscale scores were lower and the 'fitness orientation' scores higher in the AS group. The COPE active coping subscale had a weak, positive correlation with MBSRQ total score and a weak, negative correlation with BASFI score. MBRSQ total score had a moderate, negative correlation with BASFI score, and a weak, negative correlation with BASDAI score. Conclusion: The attitudes to coping with stress in AS patients with no accompanying medical disease or psychiatric disorder may not differ from that in healthy controls. Negative health evaluation and fitness orientation must be characteristics considered in psychotherapeutic interventions applied to these patients. In addition, psychotherapeutic interventions directed toward coping with stress and body image may be especially useful in active stages of the disease and in patients with limited functional capacity. [ABSTRACT FROM AUTHOR]

Introduction: Obesity is more common among patients with bipolar disorder as compared to normal population. There are studies showing increased leptin levels in obese patients. The aim of the present study was to investigate the alterations in leptin levels, body mass index (BMI), and lipid-lipoprotein levels during manic period, as well as during euthymic period, after one month in patients with bipolar disorder. Methods: Thirty-one adult patients, who had been hospitalized in the psychiatry clinic because of manic period of bipolar disorder, were included in the present study. Serum leptin and lipid-lipoprotein levels and BMI of the patients were analyzed both on the first day and 30th day of hospitalization after they became euthymic. Results: Total cholesterol and triglyceride levels significantly increased in male patients (p<0.05). The increase in total cholesterol and LDL-C levels was not significant in female patients (p=0.066 and p=0.056, respectively). BMI was significantly, but slightly increased in both genders (0.56±0.14 kg/m2), however, such a change was not observed in serum leptin levels. Conclusion: Results of the present study demonstrated that clinical improvement in bipolar patients showed different association in each gender with the alterations in BMI and serum lipid and/or lipoprotein levels. Such an alteration might have resulted from direct or indirect effect of drugs, as well as from lifestyle changes. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to investigate coping strategies suggested to be a determinant of suicide attempt and to compare them with coping strategies of healthy volunteers. Methods: This study was conducted on 50 patients who had suicide attempts within the past two months and 52 healthy volunteers who did not have any suicide attempt. They were evaluated with the Turkish version of COPE inventory. The results were analyzed using SPSS version 15.0 for Windows. Results: In the suicide attempt group, 'active coping', 'planning', 'positive reinterpretation and growth' scores were found to be lower than that in the control group. On the other hand, 'restraint coping', 'acceptance', 'focus on and venting of emotions', 'behavioral disengagement', 'substance use' and nonfunctional coping total points were significantly higher in the suicide attempt group. The patients with depression in the suicide group were found less of the 'positive reinterpretation and growth' but more of the 'substance use' compared to the healthy group. Subjects who attempted suicide more than once tended to 'substance use' rather than 'active coping'. 'Focus on and venting of emotions' scores in suicide attempters were higher in women than in males. Conclusion: We observed that individuals who attempted suicide have fewer functional coping strategies and more nonfunctional coping strategies than who do not attempt suicide. It was determined that under stressful situations, individuals with depression tended to alcohol and substance abuse instead of positive reinterpretation and growth. In subjects who had recurrent suicidal attempts, alcohol and substance abuse was more common than active coping. Women were using focusing on and venting of emotions techniques much more than men. We assume that to monitor, and in case of necessity, to change the coping strategies in suicide attempters are vitally important for preventing suicide attempts. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to determine the relationship of suicide probability with submissive behaviors and the levels of depression in male arrestees and convicts staying in penal institutions. Methods: The study consisted of 326 male participants from five different prisons. A personal information form was used to collect the socio-demographic data, The Suicide Probability Scale (SPS), Beck Depression Inventory (BDI) and the Submissive Acts Scale (SAS) were used to determine the related psychological characteristics. Results: According to the findings, depression was determined in 69% of the inmates (convicts and arrestees), while the suicide probability rate was found to be in the proportion of 88% which is higher than in the normal population. Regarding the examination in terms of crime types, it was found that the suicide ideation rate of sex offenders or sex offender arrestees (x=18.33; ss=7.28) and the hostility rate of robbery offenders (x=16.63; ss=4.75) were much higher than that of the other types of offenders. According to the findings of the Hierarchical Regression Analysis conducted in order to define the variables predicting the subscale rates of SPS, while previous suicide attempt(s) and depression predict hopelessness rate; self-attempted suicide, witnessing suicide attempts, self-harm and depression predict suicide ideation rate. Furthermore, education status and depression symptoms predict negative self-evaluation rate, and lastly education level, witnessing suicide attempts, self-harm and depression symptoms predict hostility subscale rate. Conclusion: Factors such as social isolation, mislearning, etc. were considered to cause increased feelings of hopelessness, suicide ideation, negative sense of self and feelings of hostility in convicts and arrestees staying indoors. [ABSTRACT FROM AUTHOR]

This pilot study aimed to investigate the effect of balance training by Tetraks Interactive Balance System (TIBS) on balance and fall risk in patients with mild to moderate Parkinson's disease. Four patients with Parkinson's disease between the ages of 56 and 70 years (61.25±6.70) were applied balance training for 3 weeks by TIBS. Sociodemographic features and physical properties of the subjects were recorded. Their motor performance was evaluated by the Unified Parkinson's Disease Rating Scale (UPDRS), balance was measured using the Berg Balance Scale (BBS), Functional Reach Test (FRT), Timed Up and Go Test (TUG), and the Standing on One Leg Balance Test (SOL) and, their fall risks were evaluated by TIBS. Evaluations were performed twice, before and after treatment. Following training, Parkinson's patients showed improvements in UPDRS, TUG, BBS, FRT, SOL and fall risk. Balance training by TIBS has positive effects on balance and decreases fall risk in Parkinson's disease patients. [ABSTRACT FROM AUTHOR]

Introduction: Both narcolepsy and idiopathic hypersomnia are the main causes of excessive daytime sleepiness. In this study, we aimed to compare polysomnography (PSG) and multiple sleep latency test (MSLT) findings in narcolepsy and idiopathic hypersomnia patients. Methods: The files of patients with narcolepsy and hypersomnia who were admitted between 1995 and 2009 were reviewed. We evaluated data from 94 patients with narcolepsy with cataplexy, 49 with narcolepsy without cataplexy and 140 patients with idiopathic hypersomnia. Results: Sleep latency and REM latency were longer in idiopathic hypersomnia group than in narcolepsy with and without cataplexy group. Mean sleep latency in MSLT was the shortest in narcolepsy with cataplexy group. There was no difference in sleep efficiency, percentage of sleep stage and number of awakenings in PSG between three groups. Conclusion: The findings of the study indicated that narcolepsy patients differ from idiopathic hypersomnia patients in terms of sleep latency and REM latency in PSG. [ABSTRACT FROM AUTHOR]

Introduction: In this study, we investigated the association of migraine with the Variable Number of Tandem Repeats (VNTR), repeated as 27 base pair, gene polymorphism in intron 4 of the endothelial nitric oxide synthase (eNOS) and the insertion/deletion of angiotensin converting enzyme (ACE) gene polymorphisms. Methods: One hundred and five migraine and ninety seven healthy female control subjects were enrolled in the study. The patients were subdivided as migraine with aura and without aura, and the frequency and severity of migraine headaches were recorded. The eNOS VNTR (eNOS 4 a/b) and ACE insertion/deletion gene polymorphisms (ACE I/D) were assessed by polymerase chain reactions. Results: The allele and genotype frequencies of eNOS 4 a/b gene polymorphism showed no difference between the migraine and control groups. The genotypic distribution of the ACE I/D gene polymorphism in the migraine group significantly differed from that in the control group . The DD and ID genotype increased the risk of migraine as much as 2.571 (95% CI-1.138-5.811) and 4.453 (95% CI-2.006-9.883) compared to the II genotype. The same increased risk sustained for both genotypes in the migraine with aura subgroup, but only the ID genotype remained as the risk factor in the migraine without aura subgroup (OR- 3.750, 95% CI- 1.493-9.420). No association of gene polymorphisms with migraine frequency and severity was observed. Conclusion: Our findings support the relationship between migraine and the ACE I/D gene polymorphism. However, no association was found between migraine and the eNOS 4 a/b gene polymorphism. [ABSTRACT FROM AUTHOR]

Introduction: In recent studies, it has been suggested that there is a relationship between migraine headaches and post-traumatic stress disorder (PTSD). The PTSD has not been diagnosed by a clinician in these studies; the evaluation has been carried out by the screening scales. Besides, it has also been asserted that there was relationship of alexithymia with migraine and other chronic painful disorders. In this study, our aim was to investigate the prevalence of clinically-diagnosed PTSD and alexithymic features among migraine patients. Methods: Sixty consecutive migraine patients sent from neurology clinic and 60 healthy controls having similar features constituted the sample of this study. SCID-I/CV PTSD module and the Clinician-Administered PTSD Scale (CAPS) was administered to the sample. The subjects also filled in the socio-demographic data form and the Toronto Alexithymia Scale (TAS). The level of pain perceived by the migraine patients was evaluated using a Visual Analog Scale (VAS). Results: 17 subjects (28%) in the migraine group and 5 individuals (8.3%) in the control group were diagnosed with PTSD. Hence, PTSD was found to be statistically significantly higher in the migraine group. 25 persons in the migraine group (41.6%) and 12 in the control group (20%) scored above the TAS cutoff score in terms of alexithymic features. Alexithymia was found to be statistically significantly higher in the migraine group). In the migraine group, VAS scores of the ones with PTSD were statistically significantly higher compared to that in ones without PTSD. 94% of the persons diagnosed with PTSD in the migraine group reported that their migraine headaches started after a traumatic experience. In the migraine group, no statistically significant correlation was detected between CAPS and VAS scores in subjects with PTSD. Conclusion: In migraine patients, PTSD and alexithymic features have been found higher than in the healthy controls. Further studies are needed to search whether the practices aimed at treating the PTSD and alexithymic features can contribute to the treatment of migraine headaches or not. [ABSTRACT FROM AUTHOR]

Giriş: Yüzyıl önce Kraepelin, şizofreninin ayırt edici özelliğinin, ilerleyici olarakkötüleşme göstermesi olduğunu belirtmiştir. Şizofrenide Kraepelin ölçütleribeş yıl boyunca (i) sürekli hastane yatış hikâyesi, yatmayanlarda günlük yaşamaktivitelerinde başkasına tam bağımlılık, (ii) gerçek bir iş edineme ve (iii) tamdüzelmenin yakalanamaması olarak tanımlanmıştır. Bu araştırmada Kraepelinölçütlerini karşılayan şizofreni hastalarının klinik görünümleri ve yapısal biyolojiközelliklerinin Kraepelin ölçütlerini karşılamayan şizofreni hastaları ve sağlıklıkontrollerle karşılaştırılması amaçlanmıştır.Yöntemler:Kraepelin ölçütlerini karşılayan 17 ve bu ölçütlerin dışında kalan 30şizofreni hastası ile 43 sağlıklı birey örneklemi oluşturdu. Klinik özellikler KlinikGlobal İzlenim (KGİ) Ölçeği, Pozitif ve Negatif Sendrom Ölçeği (PANSS) ile bilişselişlevler Frontal Değerlendirme Bataryası (FDB), Sözel Akıcılık (SA) ve Renk İzlemeTestleri (RİT) ile değerlendirildi. Yapısal özelliklerin değerlendirilmesinde beyninmanyetik rezonans (MR) görüntülemesi ve dermatoglifik değerlendirilmesi yapıldı.Bulgular:Şizofreni grupları arasında hastalık süresi, yatış öyküsü, intihar öyküsü,geliş şekli, stresör varlığı, tedavi açısından farklılık yoktu. Kraepelin ölçütlerinikarşılayan şizofreni hastalarında aile öyküsü ve ilaca yanıtsızlık daha yüksek orandasaptandı. Kraepelin ölçütlerini karşılayan şizofreni hastalarında PANSS’ın tüm altölçekleri ve KGİ puanları daha yüksekti. Kraepelin ölçütlerini karşılayan grubundiğer şizofreni hastalarına göre bilişsel işlevlerden yalnızca kategori akıcılığında veRİT-I’de farklılık gösterdiği saptandı. Üç grup arasında MR ve dermatoglifik ölçümdeğerleri açısından istatistiksel olarak anlamlı fark belirlenmedi.Sonuç:Kraepelin ölçütlerini karşılayan şizofreni grubunda performansın düşüksaptandığı kategori akıcılığı, dejeneratif süreçlerde önemli bir gösterge kabuledilmektedir. Şiddetli klinik belirtiler, ailesel özellik ve tedaviye yanıtsızlığın bu gruptatoplanması gelecekte küme analizini içeren bir yöntem ile çalışmalar yapılmasıgereğine işaret etmektedir. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the study was to evaluate injuries in patients with epilepsy and some factors associated with injury. Methods: This study included 126 epileptic patients who attended a neurology outpatient clinic of a hospital between March 2009 and March 2010. Data were collected using a patient information form and an injury evaluation form. The data were evaluated using percentage, mean and the Chi square test. Results: 82.5% of patients have sustained injury due to an epileptic seizure. Soft tissue injuries were the most common (70.2%), followed by head injury (61.5%), dental and tongue injury (%58.6), burns (24%), and orthopaedic injury (21.2%). The most common site of burns were the upper extremities and the face (36% and 24%, respectively). Burns occurred during cooking in 32% of cases. Five patients had upper extremity fractures. Four patients faced the risk of bathtub drowning. The injuries usually occurred at home. The significant risk factors for injury were generalized tonic-clonic seizures and high frequency of seizures. Twenty-six patients were taken to the emergency unit due to an injury. Conclusion: Injury is a common problem in patients with epilepsy. Dental and tongue injury was the most common seizure-related injury. The risk factors were generalized tonic-clonic seizures, and high frequency of seizures. Patients with epilepsy can lead normal lives but certain precautions are needed to prevent seizure-related injuries. [ABSTRACT FROM AUTHOR]

Giris: Bu çalismada ergen ve genç eriskin psikiyatri poliklinigine basvuran hastalarda kasitli kendine zarar verme davranislari ile çocukluk çagi travmalarinin yayginligi ve arasindaki iliskinin saptanmasi amaçlanmistir.Yöntemler: Çalismaya 1 ay boyunca Bakirköy Ord. Prof. Dr. Mazhar Osman Ruh Sagligi ve Sinir Hastaliklari Egitim ve Arastirma Hastanesi, Ergen ve Genç Eriskin Psikiyatri ikinci basamak poliklinigine ardisik basvurarak takip ve tedavi edilen tüm hastalar alindi. Çalismaya katilan 300 hastaya sirasiyla sosyodemografik veri formu, çocukluk çagi travmalari ölçegi (CTQ-28), çocukluk çagi kötüye kullanimi soru listesi, kasitli kendine zarar verme ve niyet etme tarama formu verildi.Bulgular: Çalismaya katilan tüm hastalarda kasitli kendine zarar verme orani %50,0 olup bu oran kizlarda %56,8, erkeklerde %28,8 olarak bulundu. Çalismaya katilan tüm hastalarin %57,0'sinde çocukluk çagi kötüye kullanimi saptandi. Kizlarin %60,4'ünde, erkeklerin %46,6'sinda çocukluk çagi kötüye kullanimi oldugu bulundu. Çocukluk çagi kötüye kullanimi kasitli kendine zarar verme davranisi olan grupta %71,3 oraninda iken, bu oran kasitli kendine zarar verme davranisi olmayan grupta %42,7 oraninda idi.Sonuç: Kasitli kendine zarar verme davranisinin ergen psikiyatrik hasta popülasyonunda yüksek oldugu, kizlarda erkeklerden daha sik görüldügü, çocukluk dönemi istismar ve ihmal yasantilarinin azimsanmayacak bir oranda ve kendine fiziksel olarak zarar verme davranisi ile iliskili oldugu görülmüstür. [ABSTRACT FROM AUTHOR]

Introduction: In this study, we aimed to investigate and compare the sociodemographic and clinical characteristics of involuntary psychiatric inpatients and that of voluntary psychiatric inpatients. To our knowledge, there has been no study analyzing involuntary psychiatric hospitalization in our country. Methods: In this retrospective study, we included a total of 504 patients who were involuntarily or voluntarily hospitalized in Bolu Izzet Baysal Mental Health Hospital between 1st of May and 31st October 2010. The data were obtained from the hospital records. Results: In the 6-month period, 13.1% of 504 inpatients were hospitalized involuntarily The number of male patients who were involuntarily hospitalized was higher than female patients. Most of patients in the involuntary hospitalized group had primary school graduate, were not married and were not working at the time of the hospitalization. Schizophrenia was the most common diagnosis in involuntarily hospitalized psychiatric patients and these patients needed longer stay in the hospital. The next hospitalization of the involuntary patients was mostly involuntary. Conclusion: Most of involuntary hospitalized psychiatric inpatients were male, were not working, and had the diagnosis of schizophrenia. These general psychiatric risk factors were more important in involuntary hospitalization compared with voluntary hospitalization. We concluded that, high prevalence of involuntary hospitalization deserved further studies. [ABSTRACT FROM AUTHOR]

Introduction: In medico-legal evaluation of trauma patients, the bio-psychological effects of the trauma and the severity of the injuries require to be evaluated. In this study, assuming the fact that psychiatric assessment are not taken into consideration in physical trauma cases, we have planned to bring up the presence of psychological trauma in our medico-legally evaluated patients due to different types of traumas and review the mental findings and diagnoses in trauma victims. Methods: We retrospectively analyzed the hospital records of 1975 patients aged 18 years or older who presented to the Department of Forensic Medicine at Dokuz Eylul University School of Medicine for medico-legal evaluation between 1999 and 2009. Psychiatric assessment was performed in 142 patients by Consultation and Liaison Psychiatry Section of the university hospital. Data contained in medico-legal reports and patient records were then examined with respect to patients' age, gender, nature of traumatic events, psychiatric diagnoses, descriptive characteristics of patients, severity of trauma, and past history of mental disorder and trauma experience. Results of the medico-legal evaluations were also analyzed. Results: Of the 142 patients, 80 (56.3%) were female and their average age was 40.30±17.17 years. The most frequent traumatic events were traffic accidents (29.6%) and violence-related blunt force trauma (28.9%). The distribution of foremost psychiatric diagnoses were anxiety disorders in 69 cases (48.6%), adjustment disorders in 16 cases (11.3%) and mood disorders in 12 cases (8.5%). Among anxiety disorders, acute stress disorder (n=39) and post-traumatic stress disorder (PTSD) (n=27) were the most accounted ones. In 27 cases of the 142, it was determined that, psychiatric symptoms and findings did not cover the diagnostic criteria. Being diagnosed as having a psychiatric disorder did not significantly associated with traumatic experiences, comorbidity, marriage status, education level, and lack of health insurance. Conclusion: We assume that, the presence of a psychological trauma is crucial to be introduced not only for the health benefit but also for legal rights of the patient. The necessity of considering merely the international diagnostic criteria in determining the existence of psychiatric trauma and its severity level can bring forth some difficulties in medico-legal evaluation. [ABSTRACT FROM AUTHOR]

Introduction: In this study, we aimed to assess the behavioral problems, psychiatric disorders and neurocognitive evaluation focused on frontal lobe functions in children with rolandic epilepsy (RE) and compare them with a control group. Methods: 31 children with RE, aged 8-13,5 years were compared with a control group matched for age, sex and socioeconomic status. Behavioral problems were assessed by the Child Behavior Checklist (CBCL) and psychiatric diagnoses were established by using the Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version. Both groups of children were administered the Wechsler Intelligence Scale for Children-Revised (WISC-R), Wisconsin Card Sorting Test (WCST) and the Stroop Color and Word Test (SCWT). Results: RE group presented more psychiatric disorders than the control group. Verbal and total IQ scores in RE group were lower than in the control group. Although the groups did not differ from each other in WCST scores, children with RE displayed lower performance in SCWT. The RE group had higher externalizing and total scores in CBCL. Conclusion: It was considered that RE does not affect basic frontal lobe functions significantly, has negative effects on attention and IQ performance, and increases behavioral problems and psychiatric disorders. [ABSTRACT FROM AUTHOR]

Introduction: The study was conducted in order to investigate the effect of disease-related variables, such as socio-demographic characteristics, disease complaints, and necrosis factor (anti-TNF) use, on the body image and self-esteem in patients with rheumatoid arthritis. Methods: The data was collected by an Introductory Information Form, Body Image Scale (PfP) BIS and the Coopersmith Self-Esteem Inventory (SEI) in 120 patients with rheumatoid arthritis and in 120 healthy control group. One-way analysis of variance, Tukey HDS analysis, t-test, Kruskal-Wallis test, the Mann-Whitney U test, and Pearson's and Spearman's correlation coefficients were used to compare the data. Results: 60% of controls aged 20-44 years, 75% were women and 30.8% had bachelor's degree or above, while 60% of patients aged between 20 and 44 years, 71.7% were women and 36.7% had bachelor's or higher education. We observed that the body satisfaction and self-esteem were higher in 20-44 age group, in those with bachelor's or higher education, without additional disease, and do not use anti-TNF; while the body satisfaction and self-esteem were lower in those receiving treatment over 5 years, with changes in hand and body and with gait disturbance, and with changes in family and working life. Conclusion: The assessment of the psychosocial needs with a holistic approach and training programs for body image and self-esteem would be advisable for patients with rheumatoid arthritis who are aged 45-59 years, with low self-esteem, with additional disease, using anti-TNF, with changes in hand and body, and with primary-school education. [ABSTRACT FROM AUTHOR]

Introduction: Electrodermal activity (EDA) is an electrical activity of eccrine sweat gland stimulated by sympathetic nervous system. Skin conductance level (SCL) is measured with EDA. SCL and sweat gland activity increase in emotional situations, such as high activation, attention or stress. In this study, we investigated whether working in shifts affects attention level of nurses with EDA and explored the relationship between EDA and sex hormone. Methods: The study was carried out on nurses working night shifts (16.00-08.00 h) (n=22) and nurses working without a shift (08.00- 16.00 h) (n=20). Firstly, The Epworth Sleepiness Scale which evaluates a person's daytime sleepiness was applied to the subjects. For EDA measurement, Ag/AgCl electrodes were put on two fingers of their dominant hand. SCL was measured via MP30 system and GSR connection. The blood samples were analyzed for cortisol and ACTH hormone levels to investigate the changes in sleep and circadian rhythm. Results: It was found that there was no statistically significant difference in skin conductance levels between the groups. Moreover, in the comparison of hormone values between the groups, the cortisol levels in night shift nurses were higher than in those working without a shift. Conclusion: Night shift had no significant effect on the attention levels in the nurses. This situation is thought to be related to the fact that the nurses responsible for the night service raise their attention level to the highest point. The reason for higher level of cortisol in nurses working shifts may reflect that cortisol has no effect on the breadth of attention but reflects a high level of stress. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the metacognitive beliefs of major depression patients with and without suicidal behavior. Methods: The sample consisted of 23 suicidal and 28 non-suicidal major depression patients whose diagnosis were made by using Structured Clinical Interview for the DSM-IV Axis I Disorders (SCID-I). Anxiety and depression symptom severity were measured through Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI)). Metacognitive beliefs were measured through Metacognitive Questionnaire (MCQ) which is accepted as a measuring device of metacognitive beliefs, metacognitive processes and judgment. Results: Suicidal group's BDI score was 33.90±10.66 and BAI score was 28.77±13.72; nonsuicidal group's BDI score was 30.32±6.66 and BAI score was 23.75±11.17. The mean age of suicidal group was 25.04±8.31 years and the mean of age of non suicidal group was 28.82±7.30 years. Data were analyzed by using Mann Whitney- U, and the difference between major depression patients with and without suicidal behavior was found to be significant for the subtypes of "need to control thoughts" (z=-2.22; p=017<0.05) and "cognitive confidence" (z=-2.39; p=026<0.05). Conclusion: Cognitive confidence (confidence in memory and attention) of the suicidal group was found to be lower compared to non-suicidal group. This can be related with the decrement in the self esteem of the patients or increment in the perception and over generalization of the negative events. We suggest that the extreme responses to the items might be the indication of a tendency of "black-and-white" style of thinking. Black and white style of thinking is also a risk factor for suicide behavior. Most of the people with suicidal attempts are unable to produce alternative solutions to their problems and feel hopeless. The extreme effort to control the thoughts in suicidal group may be related to their over attention to the thoughts. (Archives of Neuropsychiatry 2013; 50: 95-99) [ABSTRACT FROM AUTHOR]

Objective: Restless legs syndrome (RLS) is a sensorimotor disease characterized by uncomfortable sensations in the legs and an urge to move the legs, increased symptoms during rest or inactivity and at night, and relief of the symptoms by voluntary movements. The prevalence of RLS varies from 5% to 15%. Although it is commonly seen in middle-and advanced-age individuals, one-third of patients experience the symptoms before 20 years of age. In this study, we aimed to determine the frequency and awareness of RLS in young-age group. Methods: Our study was conducted among the students at Ordu University. The participants were interviewed based on a questionnaire. The subjects were interviewed for personal information and then they were asked the four questions essential for a diagnosis of RLS. Results: A total of 163 students - 60 female (37%) and 103 male (63%) - participated in the study. The frequency of RLS was 26% (n=16) in females and 13% (n=14) in males. 23.3% (n=7) of participants with RLS answered "yes" the question "Do you consult a doctor for your complaints?". Of these students, 10% (n=3) preferred a neurologist and 13.3% (n=4) stated that an orthopedist should be consulted. Conclusion: Results of our study showed that patient awareness of RLS was very low and the patients did not have enough knowledge about the disease. (Archives of Neuropsychiatry 2012; 49: 175-179) [ABSTRACT FROM AUTHOR]

Objective: The study was designed to determine the burden of caregivers of stroke patients and the factors affecting the burden. Methods: This descriptive research was conducted at Turkey İzmir Atatürk Education and Research Hospital, Clinic for Neurology with the participation of 80 caregivers who agreed to take part in the research between January 15 and March 15, 2007. Data were collected using an introductory information form and the Caregiver Burden Inventory. Results: The average Caregiver Burden Inventory subscales scores were time-addition burden 15.31±4.07, developmental burden 8.19±4.46, physical burden 6.88±3.93, social burden 5.55±4.40, emotional burden 3.44±4.25. The average total burden score was 39.36±13.83. There was found relationship between the ages of caregivers and the time-addiction burden; the social security and emotional and total burden; the requesting state to receive caregiver training and emotional burden; and the encountered difficulties in coping strategies and the average score for the physical burden subscale (p<0.05). Conclusion: In accordance with the aforementioned results, it has been concluded that taking care of a family member in need is perceived as a task and responsibility in Turkish society. Parallel to this, caregivers are not aware of their burden throughout the process and have difficulty in expressing the hardships they experience. (Archives of Neuropsychiatry 2012; 49: 169-174) [ABSTRACT FROM AUTHOR]

Background: To determine and to compare the activity status, quality of life, exercise perception and fatigue in patients with clinically isolated syndrome (CIS) and multiple sclerosis (MS), both in remission. Method: Demographic and medical statuses of 12 CIS and 9 MS patients, who were included in the study, were recorded. Disability [The Expanded Disability Status Scale (EDSS)], pain [Visual Analog Scale (VAS)], walking difficulties [The 12-Item Multiple Sclerosis Walking Scale (MSWS-12)] fatigue [The Fatigue Impact Scale (FIS)], quality of life [The MS International Quality of Life questionnaire (MUSIQoL)], results of symptoms/limitations [The MS Impact Scale (MSIS-29)], exercise participation [The Exercise Benefits and Barriers Scale (EBBS)] and physical activity status [The Physical Activity and Disability Survey (PADS), - with one question)] were evaluated. Results: There was no any significant differences between MS and CIS patients according to EDSS and VAS scores (p=0.503, p=0.066, respectively). The differences in mean scores of MSWS-12(p=0.405), MSIS-29(p=0.226), MUSIQoL(p=0.117), FIStot( p=0.302), FIS-cog (p=0.801), FIS-phy (p=0.298), FIS-soc (p=0.163) and PADS (p=0.085) between the groups were not statistically significant. Additionally, all subjects reported activity avoidance and lower activity status after the diagnoses. The differences in mean scores of EBBS-total, EBBS-benefit and the EBBS-barrier between the groups were not statistically significant (p=0.374, p=0.569, p=0.255, respectively). A significant positive correlation was found between the MUSIQoL and FIS-total (p=0.039); MUSIQoL and MSIS-29 (p=0.001); MSWS-12 and MSIS-29 (p=0.010). Conclusion: It was found that the patients with newly diagnosed CIS and MS,both in remission have diminished their activity status and exercise participation in the same way. Besides, they developed activity avoidance with negatively influenced quality of life and fatigue. The possible and rapid alterations in physical activity level in these patients may be useful for rehabilitation teams to develop new strategies for reducing these negative effects. (Archives of Neuropsychiatry 2013; 50: 116-121) [ABSTRACT FROM AUTHOR]

Objective: To explore the effects of 12-week supervised exercise program (SEP) on quality of life (QoL), walking abilities, balance impairment and fatigue in patients with multiple sclerosis (MS) and to compare these outcomes according to the severity of the disability.Methods: Demographic characteristics and medical history of a total of 24 MS patients were recorded. Disability [The Expanded Disability Status Scale (EDSS)],functional balance [The Berg Balance Scale (BBS)], balance confidence [The Activities-pecific Balance Confidence (ABC)_Scale], walking difficulties [The 12-Item Multiple Sclerosis Walking Scale (MSWS-12)], fatigue [The Fatigue Impact Scale (FIS)], QoL [The MS International Quality of Life (MUSIQOL)] were evaluated before, at the end of the treatment (3rd month) and at the 6th month. Additionally,the effectiveness rate of the physiotherapy was calculated according to the disability and disease duration.Results: The outcome results of the 17 participants with a mean age of 45.2±8.6 years(seven patients were excluded because of acute attacks) showed that the differences between the mean scores of MSWS-12, BBS and ABC_Scale were resulted from the2nd assessment (p<0.001), and this differences remained at the follow-up measurements (p<0.001, p=0.003, p=0.001, respectively). The differences between the MUSIQOL scores were resulted from the 3rd assessment at the follow-up (p=0.014).There were statistically significant and positive correlation between the scores of MUSIQOL significantly positively correlated with scores of FIS-total and subgroups, in addition, MSWS-12 significantly positively correlated with MUSIQOL, BBS, ABC_Scale,FIS-total and subgroups, and EDSS scores (p<0.05).Conclusion: 12-week SEP was resulted in similar improvements in QoL and walking abilities in both patients with low and severe disabilities. Additionally, these findings strongly suggest that treatment for walking abilities may also extend to improvements in QoL. Therefore, the rehabilitation team should consider the benefits of regular exercise and should focus and encourage people with MS to participate in exercise independent from the disease severity. (Archives of Neuropsychiatry 2013; 50: 23-29) [ABSTRACT FROM AUTHOR]

Background: Sensorimotor polyneuropathy or mononeuropathy caused by damage of axon or myelin have been reported in patients with clinical hypothyroidism; however, there are conflicting results concerning peripheral neuropathy involvement due to subclinical hypothyroidism. Our aim in this study was to investigate the electrophysiological changes in median and ulnar nerves in patients with clinical hypothyroidism or subclinical hypothyroidism that is asymptomatic from the neurological point of view. Method: 15 patients (30 hands) with clinical hypothyroidism (group 1) and 18 patients (36 hands) with subclinical hypothyroidism (group 2), who were asymptomatic from the neurological point of view, were included in the study. 27 age- and gender-matched healthy individuals (54 hands) were taken as a control group. The median and ulnar nerves were assessed electrophysiologically in the groups. Results: Slowing of ulnar motor nerve conduction velocity (uMNCV) and ulnar nerve sensory latency (uSDL) elongation values in group 2 were found to be significant compared to the control group. When group 1 was compared with the control group, elongation in the median motor distal latency (mMDL), slowing in median motor conduction velocity (mMNCV), reduction in median nerve compound muscle action potential (mCMAP), and a significant decrease in ulnar motor conduction velocity (uMNCV) were found in group 1. When group 1 was compared with group 2, in patients with clinical hypothyroidism, elongation in mMDL and amplitude reduction in mCMAP were found, no statistically significant differences were found between the groups in terms of median sensory nerve conduction velocity (mSNCV), mMNCV, median distal sensory latency (mSDL), uMNCV, ulnar sensory nerve conduction velocity (uSNCV), ulnar compound muscle action potential (uCMAP), and uMDL values. Conclusion: Even before the emergence of neurological symptoms in patients with clinical and subclinical hypothyroidism, abnormalities can be detected in nerve conduction studies. We believe that, assessment of these patients for peripheral neuropathy by conducting routine nerve conduction studies will contribute to early diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Background: To investigate the effects of disability and specific treatments on depression associated with multiple sclerosis (MS). Methods: Fifty-two patients with MS (patient group) and 48 healthy subjects (control group) participated in the study. While the Beck Depression Inventory (BDI) and the Expanded Disability Status Scale (EDSS) were administered to the patients, healthy controls filled out only the BDI. Psychiatric disorders were determined using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Result: Both groups were found to be identical in their socio-demographic properties. The mean age of onset of MS was 29.1±1.2 years. There was no difference between males and females in terms of depression. The patient group consisted of patients with: relapsing-remitting MS (71.2%), secondary-progressive MS (13.5%), progressive-relapsing MS (11.5%), and primary-progressive MS (3.8%). A 12-fold increased risk for depression was found among patients with MS. Age, attack number and illness duration did not correlate significantly with risk for development of depression in MS. However, a significant relationship was found between EDSS scores and the risk for the development of depression. Depression was detected in patients using azathioprine (100%), interferon beta-1a SC (88.8%) and in patients not receiving any treatment (78.5%). Conclusion: This study indicates that, disability is an important risk factor for the development of depression, irrespective of the treatment modality. [ABSTRACT FROM AUTHOR]

Objective: To assess the frequency of cognitive impairment in patients with relapsing-remitting multiple sclerosis (RRMS) using the Brief Repeatable Battery (BRB), as well as to explore the associations of cognitive impairment with demographic and clinical parameters and to evaluate its relation with physical impairment and quality of life. Methods: Patients admitted to our hospital's Multiple Sclerosis and Demyelinating Diseases Outpatients Clinic between March and May 2010 were assessed using the BRB, Multiple Sclerosis Neuropsychological Questionnaire (MSNQ), Beck depression inventory (BDI), and the Functional Assessment of MS Quality of Life Instrument (FAMS). Results: Fifty-one patients fulfilled the study criteria. Mean test scores of the study group were PASAT 42.76±30.41; 10/36 Spatial Recall Test (SPART)-Total Learning (TL) 18.4±6.2; delayed recall (DR) 6.8±3.2; Selective Reminding Test (SRT)-TL 5.67±2.00; SRT-DR 4.67±2.00; Symbol-Digit Modalities Test (SDMT) 29.84±19.50; Word List Generation (WLG) 14.14±5.74. The mean score of MSNQ patient form was 10.27±11.95; BDI mean score was 20.20±12.17; FAMS mean score was 64.18±46.52. 41.17% of patients had cognitive impairment. Age, education level, and EDSS scores correlated with cognitive impairment (p<0.01; p<0.05; p<0,01 respectively). There was no correlation between cognitive impairment and either gender or disease duration (p>0.05; p>0.05, respectively). Patients with cognitive impairment had higher depression scores (p<0.01) and lower quality of life scores (p<0.01). Discussion: Cognitive impairment is a common problem in RRMS patients and plays a major role in the quality of life. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present research is to evince the efficiency of technics for individual defence and intervention for agression that might be applied individually or in team in order to control agressive behaviour and physical violence of patients in the psychiatry clinics by the means of preeducation and post-education tests. Methods: The research is undertaken with 109 nurses who participated into 'The course of individual defence and intervention to agression technics' in January- March 2010 in Bakıırköy Mental Hospital. Results: The qualities of the nurses participated into the research are as follows: their ages change between 21 and 59 and age-avarage is 36.77±8.9; of % 63.3 women , of %62.4 married, of %41.3 Graduate of Health High School, of %56.0 clinical nurse, of %57.8 those who were exposed to physical violence by patients. Regarding results revealed during the research, we reached a general total point for 24 questions about behaviours and level of knowledge of patient demonstrating physical aggression. This point ranges between 24 and 120. When the result is converted into the centenarian system, the statistical difference of 5,69 related to the increase in the total points of post-education compared to pre-education level is. Conclusion: The present research maintains that the ratio of the physical agression staff-nurses working in psychiatry clinics are exposed is high, and apart from security precautions and security personel, it is essentially important for staff-nurses to know the personal defence technics, in terms of providing personal protection in emergency situations until professional help arrives. In addition to that it is also the fact that bed capacity in psychitry clinics are to be reduced to provide a theraupetic environment and more regulations concerning the precautions to increase security level of nurses are to be enacted. [ABSTRACT FROM AUTHOR]

Objective: It is argued that different cognitive and neuropsychological features are involved in the presentation and permanency of symptoms in children and adolescents with obsessive-compulsive disorder (OCD). The aim of this study was to explore possible cognitive and neuropsychological variations between treatment-naive children and adolescents with OCD and healthy controls. Methods: Children and adolescents with OCD aged between 8 and 16 years (n=45) and healthy controls matched for age, sex and hand preference (n=45) were recruited for the study. The groups were compared with the WISC-R, Wisconsin Card Sorting Test, Stroop Test-TBAG form, Trail Making Test A/B, verbal fluency and category fluency tests, category alteration test and the Rey auditory verbal learning test. Results: Despite the similar full-scale intelligence quotient (IQ) scores in the two groups, OCD group had significantly higher verbal IQ and lower performance IQ. We found weakness in visuospatial perception, visual scanning, immediate verbal memory and immediate verbal learning as well as cognitive strength in long-term verbal memory in OCD group. We could not detect any statistical differences in verbal fluency, attention, working memory, response inhibition, interference control, speed of information processing, psychomotor speed, set shifting, concept formation and reasoning between the two groups. Conclusion: Some cognitive-neuropsychological weaknesses and strengths could be involved with presentation of OCD symptoms in children and adolescents. [ABSTRACT FROM AUTHOR]

Objective: It is well known that more than half of subjects with attention-deficit hyperactivity disorder (ADHD) have comorbid psychiatric disorders. There is increasing evidence that psychiatric comorbidity effects the manifestation and severity of symptoms, long-term prognosis, treatment response and quality of life in patients diagnosed with ADHD. The aim of this study was to investigate the frequency of psychiatric disorders and effects of age, gender and ADHD subtypes on comorbidity in children and adolescents with ADHD. Methods: The study group included 133 children and adolescents who were referred to the Department of Child and Adolescent Psychiatry, Meram Faculty of Medicine, Selcuk University. All cases were diagnosed as ADHD according to DSM-IV criteria. Comorbid psychopathology was evaluated by using a standardized diagnostic instrument, The Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL). Results: Ninety-eight (73.7%) subjects had at least one comorbid psychiatric disorder. The most common comorbid disorders were disruptive behavior disorders and anxiety disorders. There was no effect of gender on psychiatric comorbidity. Conduct disorder, mood disorders and substance abuse were more frequent in adolescents than in children. In ADHD - Combined subtype, disruptive behavior disorders were more prevalent. Conclusion: The results of this study confirm that psychiatric comorbidity in children and adolescents with ADHD is very high as it was demonstrated in previous studies. Evaluation of comorbid psychiatric disorders during assessment of cases with ADHD is important. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to investigate the effects of hemodialysis and peritoneal dialysis on the peripheral and central nervous system in patients with uremia associated with chronic renal failure. Met hod: In this study, 35 hemodialysis and 35 peritoneal dialysis patients were compared with 70 healthy controls by working in blink reflex after assessment of peripheral neuropathy by neurological examination and performing EMG. Re sults: Ipsilateral R2 (R2i) and contralateral R2 (R2c) response latencies were found to be significantly prolonged in patients with chronic renal failure compared to those of controls. Also, latencies of R2 responses in hemodialysis patients, in whom polyneuropathy was detected, were significantly longer than those of the peritoneal dialysis patients, while latencies of R1 responses were unaffected. C onc lu si on: For extraaxial lesions, R2 is less sensitive than R1, but in intraaxial lesions abnormality of R2 is as frequent as short latency responses, the R2 being more complex and spreads to the caudal medulla. Hence, in chronic renal failure patients sparing of the R1 and prolongation of the R2 indicates a subclinical intraaxial involvement. There was no significant difference in R1, R2i and R2c values between peritonal dialysis patients with polyneuropathy and controls. R1 values in hemodialysis patients with polyneuropathy were found to be within normal range while R2i and R2c values were significantly prolonged when compared to controls; suggesting that intraaxial subclinical involvement is more frequently seen in hemodialysis patients. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate quality of life in children and adolescents with attention-deficit hyperactivity disorder (ADHD), to determine the relationship between severity of the disorder and existence of comorbidity, and to compare the results with those in healthy control group. Methods: Forty-nine children aged 8-16 years and diagnosed with ADHD based on the Schedule for Affective Disorders and Schizophrenia for School-age Children-Turkish Version (K-SADS-PL-T) and interview for the Diagnostic and Statistical Manual of Mental Disorders-IV Edition (DSM-IV) w ere enrolled in the study as well as 49 healthy age- and gender-matched controls. Quality of life in all children was evaluated by the Pediatric Quality of Life Inventory (PedsQL), and symptom severity in children with ADHD was assessed by the Turgay DSM-IV-Based Child and Adolescent Behavior Disorders Screening and Rating Scale (T-DSM-IV-S). Results: The ADHD samples showed significantly lower total scale score, school functioning and psychosocial health summary scores than the healthy children. The quality of life based on subscale scores and total scale scores, except physical health and emotional functioning scores, was found significantly lower in parents of children with ADHD than in parents of healthy children. When the relationship between ADHD symptom severity and PedsQL scores was evaluated, medium-level negative correlation was found between T-DSM-IV-S total scores and psychosocial health total score, social and school functioning scores for PedsQL filled out by parents. It was observed that 17 children with ADHD with comorbid diagnoses had significantly lower subscale scores and total scale scores for PedsQL filled out by children, except for physical health total scores and social functioning scores, compared to 32 children without comorbidity. As for the PedsQL filled out by the parents, no statistical difference was found between the scores of children with comorbidity and without comorbidity. Conclusion: ADHD, a chronic neuropsychiatric disorder, was seen to be affecting life quality negatively based on reporting by both children and parents. It can be assumed that evaluation of life quality during observation and treatment of ADHD may become a guide to finding areas, in which children have difficulties. [ABSTRACT FROM AUTHOR]

Objective: Double peak sensory responses elicited with submaximal stimulation is an electrophysiological method that has not been studied previously in pathological conditions. The second peak of the response was claimed to be produced by anodal stimulation and originated from the most distal regions of the nerve fibers. The objective of the study was to test double peak sensory responses in two groups of diabetic patients in two different stages of the disease. Methods: Conventional nerve conduction studies performed in 20 patients with impaired glucose tolerance (IGT), 14 with type 2 diabetes mellitus (DM), and in 25 healthy control subjects revealed normal results. Orthodromic double peak sensory responses with submaximal stimulation of the median nerve, sural/radial amplitude ratio and medial plantar nerve orthodromic sensory nerve action potentials (SNAP) were also studied in the non-dominant side. IGT and DM patients were evaluated with the Michigan Diabetic Neuropathy Scale (MDNS). Results: The mean median nerve sensory distal latency was prolonged and ulnar SNAP amplitude was significantly reduced in DM patients compared to the subjects in the other two groups. DM and IGT patients had higher stimulation thresholds and maximal stimulation intensities than the control subjects. The latencies of the first and second components of the double peak sensory responses were also prolonged in the DM group compared to the other groups. Conclusion: This study did not reveal any result indicating that double peak sensory responses with submaximal stimulation were superior to conventional nerve conduction studies in the detection of early diabetic polyneuropathy. However, the number of subjects included in our study is insufficient for a final decision on this matter, and further studies are needed to include diabetic patients having clinical signs and symptoms of polyneuropathy and normal nerve conduction studies. Stimulation threshold assessment might be a promising tool for the detection of early nerve involvement, if its reproducibility is achieved. This study showed once more that peripheral neuropathy may develop in individuals with diabetes even in early stage and with good glycemic control. [ABSTRACT FROM AUTHOR]

Objective: Although it is widely accepted that inpatient psychiatric treatment of children and adolescents is effective, it is also essential to evaluate its effectiveness by assessing the treatment compliance following discharge and the persistence of treatment effects in the long run. The aim of this study is to assess the effectiveness of inpatient treatment provided in one of the rare units in our country via evaluation of the achievement of treatment goals, changes in risk assessment scores, treatment compliance following discharge, and psychological functioning as reflected in the current relationships with the family, peers and school. Methods: This study was conducted in patients who had received at least 2 weeks of inpatient treatment in Dokuz Eylul University Hospital, the Child and Adolescent Mental Health Inpatient Unit between February 2008 and January 2009. Achievement of treatment goals, changes in risk assessment scores, treatment compliance following discharge, and the level of general functioning w ere assessed 1 year after the discharge. Socio-demographic variables, psychiatric diagnosis, and duration of hospital stay were recorded for each patient. Treatment goals questionnaire, risk assessment procedure, assessment of treatment compliance following discharge, relations with peers, family and school, and general functioning were assessed with the The Children's Global Assessment Scale (CGAS). Results: Forty-six patients with a mean (Standard Deviation, SD) age of 16.2 (1.6) years were included in the study. It was observed that 84.7% of patients had good compliance with the outpatient treatment plans. The mean (SD) CGAS scores calculated at admission, discharge and 1 year following the inpatient treatment were 40.6 (8.8), 60.7 (9.0) and 65.1 (1.7), respectively. The change in CGAS scores was found to be statistically significant (p=0.000). Additionally, the risk assessment scores were significantly lower 1 year following the discharge (p=0.000). Conclusion: Data obtained from the study display that the inpatient treatment of children and adolescents showed marked improvements in their psychiatric morbidities, peer, family and school functioning and outpatient treatment compliance. These findings could indicate the necessity of establishing and improving child and adolescent inpatient units in our country. [ABSTRACT FROM AUTHOR]

Objective: In this retrospective chart review study we aimed to investigate the effect of pimozide augmentation on schizophrenia patients with poor or partial response to clozapine therapy. Methods: Charts of 17 treatment resistant schizophrenia patients who had poor or partial response to at least one year clozapine therapy and whose treatment was augmented with pimozide were evaluated. Patients who had Clinical Global ImpressionSeverity (CGIS) scores ≥4 and Positive and Negative Syndrome Scale (PANSS) scores ≥72 were considered as poor or partial clozapine responders. The scores on the PANSS, CGI scale, and Extrapyramidal Symptom Rating Scale (ESRS) obtained in the first and the third months of follow-up were evaluated. Results: The mean age of the 8 female and 9 male (total 17) patients was 32.23±7.87 years, the mean age at onset of illness was 19.94±4.19 years, the mean duration of illness was 12.29±6.12 years, the mean clozapine dose was 500±58.63 mg/day, and the mean pimozide dose was 3.88±0.60 mg /day. The mean PANSS scores decreased from 99.70±13.91 to 3.64±1.27 and the mean CGIS scores decreased from 4.82±0.80 to 3.64±1.27. ESRS scores did not change significantly after the addition of pimozide to the treatment. Conclusion: Pimozide augmentation of clozapine was found to be effective and safe in treatment resistant schizophrenia patients with poor or partial response to clozapine therapy. [ABSTRACT FROM AUTHOR]

Kleine-Levin Syndrome (KLS) is a rare disorder characterized intermittent hypersomnia, hyperphagia, hypersexuality, abnormal behaviors, and confusion. Patients are asymptomatic between episodes. The aim of this case series study was to determine the clinical features of patients with KLS and to compare the polysomnography (PSG) findings between symptomatic and asymptomatic periods.We compared the results of PSG investigations performed in symptomatic and asymptomatic periods in six patients diagnosed with KLS at Gulhane Military Medical Faculty Sleep Research Center between 1998 and 2005. The age at onset of KLS was approximately 18 years, the diagnosis delayed 2.67 years, hypersomnia episodes lasted approximately 11.5 days, until the correct diagnosis, the patients had experienced on average 5 episodes. Total sleep time in KLS patients during symptomatic period and stage 2 sleep percent was higher than in asymptomatic period. REM latency was shorter and stage 3 and REM percent was lower in asymptomatic period. The clinical features including the age of onset and episode duration are compatible with those from the previous studies. It was observed that the sleep architecture during symptomatic period was different from that in asymptomatic period. [ABSTRACT FROM AUTHOR]