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Background: Assaults on health professionals have been an area of burgeoning clinical and political interest in recent years. There is now a body of literature suggesting that violence towards psychiatrists is more common than to other doctors. Thus far the vast majority of research in this area has been conducted in Western European and North American clinical settings. For the first time, this study examines this issue in the context of Turkish psychiatric settings., Objective: (i) The study aims to detect the prevalence of verbal and physical assaults towards psychiatrists in Turkey. (ii) It aims to compare the experience of verbal and physical assaults according to the gender and training experience of psychiatrists. (iii) The paper intends to investigate how psychiatrists reacted to and appraised the experience of violence., Methods: A questionnaire was prepared to evaluate violence towards psychiatrists (adapted from the Overt Agression Scale). The questionaire was administered to psychiatric specialists and residents working in state hospitals, research and training hospitals, mental health hospitals and university psychiatry clinics. A response rate of 93% was achieved with 186 out of 200 psychiatrsits approached completing the study questionnaire., Results: Of all the psychiatrists who responded, 71% reported having experienced verbal or physical assaults during their professional life (verbal assaults only (19.9%), physical assaults only (2.7%) and both (48.4%)). Of these, 26% suffered injury to at least a mild degree. There was no statistically significant difference in terms of gender and workplace. In spite of the extremely high rates of aggression and violence towards psychiatrists, roughly 50% perceived these acts a normal part of their job and only 5% formally reported the violent incident., Conclusion: The majority of psychiatrists described having been victims of verbal and physical assaults although half perceived aggression and violence as a normal part of their job. Levels of reporting of violence were very low in the context of this study. Studies such as this provide evidence to inform the development of improved management of violence and may encourage psychiatrists to report violence.

Background: Bipolar patients spend up to one third of their lives in depression however, acute treatment guidelines mainly focused on the manic phase of illness. With recent attention to the importance of evidence-based medicine in psychiatry, a number of treatment guidelines have emerged to aid clinicians in clinical decision making. Here, we aim to measure concordance with the Turkish Psychiatric Association Treatment Guideline for Bipolar Disorders (TPATGBD) for the depressive phase of illness., Subjects and Methods: Bipolar patients attending the Rasit Tahsin Mood Disorders Outpatient Unit of Istanbul Bakırköy Research and Training Hospital for Psychiatry, Neurolgy & Neurosurgery, were assessed using standardized forms based on a nation-wide mood disorders follow-up program. Concordance of implementations with the TPATGBD were evaluated step by step for each level of depression severity., Results: Concordance rates with the first step recommendations of the guideline were 29.4%, 27.4% and 87.5% for mild-moderate, moderate-severe (without psychosis) and severe depression (with psychosis), respectively. Concordance rates with the second step recommendations of the guideline were lower for bipolar depressions without psychosis. Overall, adherence to the guideline did not impact on time to remission (p=0.19)., Conclusions: Despite considerable efforts to develop and disseminate evidence-based guidelines, they are not widely followed by clinicians and important opportunities clearly exist to educate clinicians about the feasibility and utility of clinical guidelines for bipolar disorder. Systematic studies in the future are required to clarify our understanding of clinicians' attitudes to the use of guidelines and to explain the discrepancy between guidelines and clinical practice.

Objective: To determine the attitudes and behaviors of psychiatrists and psychiatry residents towards pharmaceutical representatives and their promotional activities, and to evaluate the effect of the duration of residency and type of the training institution on these attitudes and behaviors., Method: A validated questionnaire for assessing the attitudes and behaviors of physicians towards the pharmaceutical industry was administered to psychiatrists and psychiatry residents at regional meetings. Of the 1973 participants, 348 responded., Results: Although there was significant interaction between psychiatrists and pharmaceutical representatives, 50.7% of psychiatrists reported that they thought these interactions had no impact on their prescribing practices. First- and second-year residents agreed more than the other residents and the specialist that pharmaceutical representatives provided accurate information and had no effect on physician prescribing practices. First- and second-years residents agreed less than older residents that pharmaceutical representatives used marketing techniques. The psychiatrists regarded most of the pharmaceutical promotions as appropriate. State hospital staff agreed more than the university hospital staff that the pharmaceutical industry should support educational meetings in their institutions., Conclusion: There was intense interaction (3/4)characterized by undefined boundaries (3/4)between psychiatrists and the pharmaceutical industry. Most physicians were not provided any guidelines concerning their interactions with pharmaceutical representatives and there was general concern about the necessity of restricting these interactions.

Electroconvulsive therapy (ECT) is largely historical but is still in use. Modern psychiatry requires careful selection of patients in whom ECT will be performed. The indications for ECT treatment are limited, and the selection criteria should be strictly followed. The advantages and the disadvantages of the methods are discussed here. Despite the limitations, ECT seems to have real value in selected mental conditions in which it can even be considered a life-saving procedure.

Abstract Background Current evidence suggests that high concentrations of pro-inflammatory markers are associated with bipolar disorder characterized by severe impairment during inter-episodic periods, reduced treatment response and persistent subsyndromal symptoms. We tested whether persistent subsyndromal symptoms in euthymic bipolar patients were associated with markers of an ongoing chronic pro-inflammatory process. Methods Forty-five euthymic bipolar patients (22 with subsyndromal symptoms (BD+) and 23 without subsyndromal symptoms (BD-) and 23 well controls (WC) were recruited for assessment of soluble tumor necrosis factor receptor-1 (sTNF-R1), soluble interleukin-6 receptor (sIL-6R) and soluble interleukin-2 receptor (sIL-2R) concentrations. Soluble cytokine receptor concentrations were assessed using enzyme-linked immunosorbent assay. Results In comparison to WC, sTNF-R1 concentration was higher in both BD- and BD+ (age and sex adjusted standardized β, respectively: β = 0.34, p = 0.012 and β = 0.41, p = 0.003). Similarly, compared to WC, sIL-6R concentration was higher in both BD- and BD+ (age and sex adjusted standardized β, respectively: β = 0.44, p = 0.001 and β = 0.37, p = 0.008). There was no difference between BD- and BD+ in the concentration of either sTNF-R1 or sIL-6R; plasma concentration of sIL-2R was not analyzed as 75% percent of the samples were non-detectable. Conclusions Although bipolar patients present with a pro-inflammatory shift compared to well controls, subsyndromal symptoms are not associated with additive increasing effects. Longitudinal studies with larger samples are required to clarify the relationship between illness course and inflammatory markers in bipolar disorder.

Objective: To determine the attitudes and behaviors of psychiatrists and psychiatry residents towards pharmaceutical representatives and their promotional activities, and to evaluate the effect of the duration of residency and type of the training institution on these attitudes and behaviors. Method: A validated questionnaire for assessing the attitudes and behaviors of physicians towards the pharmaceutical industry was administered to psychiatrists and psychiatry residents at regional meetings. Of the 1973 participants, 348 responded. Results: Although there was significant interaction between psychiatrists and pharmaceutical representatives, 50.7% of psychiatrists reported that they thought these interactions had no impact on their prescribing practices. First- and second-year residents agreed more than the other residents and the specialist that pharmaceutical representatives provided accurate information and had no effect on physician prescribing practices. First- and second-years residents agreed less than older residents that pharmaceutical representatives used marketing techniques . The psychiatrists regarded most of the pharmaceutical promotions as appropriate. State hospital staff agreed more than the university hospital staff that the pharmaceutical industry should support educational meetings in their institutions. Conclusion: There was intense interaction–characterized by undefined boundaries–between psychiatrists and the pharmaceutical industry. Most physicians were not provided any guidelines concerning their interactions with pharmaceutical representatives and there was general concern about the necessity of restricting these interactions. [ABSTRACT FROM AUTHOR]

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Copyright of Turk Psikiyatri Dergisi is the property of Turk Psikiyatri Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turk Psikiyatri Dergisi is the property of Turk Psikiyatri Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article focuses on the higher risk of psychiatry residents to violence. It states that spending more time with patients in emergency rooms, hospital rooms and patient wards is seen to be a possible causes for the residents' higher exposure to violence. It infers that evaluating the violence against psychiatry residents were expected to experience more difficulty due to their inexperience in their field of work and the lack of structured training in coping with violence.

Empathy can be defined as the capacity to know emotionally what another is experiencing from within the frame of reference of that other person and the capacity to sample the feelings of another or it can be metaphorized as to put oneself in another's shoes. Although the concept of empathy was firstly described in psychological theories, researches studying the biological correlates of psychological theories have been increasing recently. Not suprisingly, dinamically oriented psychotherapists Freud, Kohut, Basch and Fenichel had suggested theories about the biological correlates of empathy concept and established the basis of this modality decades ago. Some other theorists emphasized the importance of empathy in the early years of lifetime regarding mother-child attachment in terms of developmental psychology and investigated its role in explanation of psychopathology. The data coming from some of the recent brain imaging and animal model studies also seem to support these theories. Although increased activity in different brain regions was shown in many of the brain imaging studies, the role of cingulate cortex for understanding mother-child relationship was constantly emphasized in nearly all of the studies. In addition to these studies, a group of Italian scientists has defined a group of neurons as "mirror neurons" in their studies observing rhesus macaque monkeys. Later, they also defined mirror neurons in human studies, and suggested them as "empathy neurons". After the discovery of mirror neurons, the hopes of finding the missing part of the puzzle for understanding the biological correlates of empathy raised again. Although the roles of different biological parameters such as skin conductance and pupil diameter for defining empathy have not been certain yet, they are going to give us the opportunity to revise the inconsistent basis of structural validity in psychiatry and to stabilize descriptive validity. In this review, the possible neurobiological background of empathy will be discussed in the light of the recent brain imaging and animal studies. [ABSTRACT FROM AUTHOR]