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Objectives:The number of forensic cases in childhood and adolescence is increasing. However, the data on the characteristics of the forensic psychiatric evaluations in the field of child and adolescent psychiatry in our country are extremely limited. The aim of this study was to investigate the sociodemographic characteristics of children and adolescents who had applied to the child psychiatry outpatient clinic in Konya in the last 5 years.Materials and Methods:In this study, archive files and reports of 523 cases referred to Necmettin Erbakan University Meram School of Medicine Department of Child and Adolescent Psychiatry between January 2014 and February 2019 were analyzed retrospectively. The age, gender, family structure, educational background, place of residence, intelligence levels and reasons for referring these children, the type of crime committed by the offenders, and the types of abuse in the victims were evaluated.Results:Of the cases admitted to our forensic psychiatry outpatient clinic, 33.7% (n=176) were evaluated for delinquency, 39.8% (n=208) for sexual abuse and 26.6% (n=139) for other reasons. The frequency of referral was significantly higher in the sexual abuse category in girls and in the delinquency category in boys (p

The aim of the current study was to determine the prevalence of probable attention-deficit/hyperactivity disorder (ADHD) in prisoners and to assess the relationship between ADHD and recidivism. We studied 356 inmates, who were evaluated using the Wender Utah Rating Scale and Adult ADHD Self-Report Scale. Type of crime and other crime-related data were compared between inmates with and without ADHD. The group with probable ADHD had a higher average number of convictions compared to the group without ADHD. The probable ADHD group also demonstrated higher incidence of extortion crime, drug trade, disciplinary action at school, and military service than the group without ADHD. Linear regression analysis revealed that the presence of probable ADHD was effective on the number of convictions. The findings of our study support that the presence of probable ADHD carries a potential risk of being prone to certain crimes and demonstrate a correlation between the presence of probable ADHD and early involvement in crime and the number of convictions.

Objective: The aims of the study were to: (i) screen for PTSD among subjects older than 15 years old living in the Ercis-Van region nine months after the earthquake; and (ii) examine the socio-demographic, clinical and trauma-related factors of PTSD diagnosis. Method: At the time of the earthquakes, the population of Ercis-Van region was 1,050,000. We selected 1498 participants in these areas: 996 from Van and 502 from Ercis, centers using a stratified sampling frame (Kish design). Demographic information, trauma related experiences and past psychiatric history was obtained via sociodemographic survey. The PTSD module of the Composite International Diagnostic Interview (CIDI), along with depression, dysthymia, social anxiety disorder, obsessive compulsive disorder, generalized anxiety disorder structured interview modules were used to directly elicit clinical information. Results: We found that PTSD was prevalent 35.5% among Van earthquake survivors. Analysis of binary Logistic regression showed risk factors, which included some trauma related losses, pre and post traumatic experiences. These risk factors are being female, having depression, loosing any family members or relatives, being unemployed, having serious familial conflicts, severe financial loss, and temporary relocation. Discussion: Our results indicate that in addition to being women, having depression, trauma related losses, like previous traumatic experiences, some pre and post traumatic risk factors are important for development of PTSD. Therefore, after the traumatic event, community based interventions should be structured based on these pre and post disaster risk factors.

Objective The current study aimed to measure and compare neurological disability in Parkinson’s disease (PD) patients with right-sided symptom onset with that in PD patients with left-sided symptom onset, using the measurements taken at their first and last visits, to determine if right-sided symptom onset was predictive of a poor PD prognosis. Methods One hundred and forty-three PD patients were included in the study. The Unified Parkinson’s Disease Rating Scale (UPDRS) and the Hoehn and Yahr Scale were used to measure neurological disability in patients at the first and last visits. The scores for the neurological disability of patients at the first and last visits were compared retrospectively relative to disease onset. Results Seventy-six PD patients had right-sided symptom onset (53%), and 67 patients had left-sided symptom onset (47%) (p = < 0.001). The differences between the scores at the first and last visits, measured using the UPDRS and the Hoehn and Yahr Scale, were higher for PD patients with right-sided symptom onset than patients with left-sided symptom onset (p = < 0.001, p = < 0.002, respectively). Similarly, the UPDRS Part II and Part III values, used to evaluate motor function, were higher in PD patients with right-sided symptom onset as compared to those with left-sided symptom onset at the first and last visits (p = < 0.001). Conclusion Right-sided symptom onset was predictive of a poor prognosis in PD patients at follow-up.

Objectives Determination of LH in urine has proved to be a reliable method for evaluation of pubertal development. The human LH assay based on time-resolved immunofluorometric (IFMA) technology (AutoDELFIA, PerkinElmer, Wallac) has been found to be suitable for this purpose thanks to its high sensitivity but other assays have not been evaluated. We have analyzed our data obtained by another potentially sensitive detection technique, enhanced luminometric assay (LIA) with the objective of finding a viable alternative to IFMA since these may not be available in the future. Methods LIA was used to measure LH and FSH in serum and urine samples from 100 healthy subjects of each Tanner stage and both genders, whose pubertal development has been determined. Results Urinary gonodotropin concentrations measured by LIA correlated well with Tanner stage [(r=0.93 for girls, r=0.81 for boys; p Conclusions Measurement of urinary gonadotropin concentrations by LIA may be useful for the evaluation of overall pubertal development and also in the detection of transition from prepuberty to puberty.

Aim:Febrile seizures (FS) are the most common seizures seen in childhood. Although they are usually benign and self-limiting, parents feel great fear and concern about them. The prevalence of FS varies in different parts of the world. These differences are thought to be due to genetic, geographic and environmental factors. However, there has been no recent study about the prevalence of FS among Turkish children. This study was designed to find out the prevalence, clinical and some epidemiological features of FS among Turkish school children.Materials and Methods:A school based, cross-sectional study was conducted in first and second grade children. A stratified cluster sampling technique was used to define the study population, which represents the schools located in the metropolitan area of İzmir. Data were collected through a standard questionnaire from the parents who agreed to be involved in the study. The survey had questions about some demographic features of the children and FS episodes.Results:Three thousand eighty hundred six children and parent pairs agreed to participate in the survey. The FS prevalence determined was 4.8% (boys, 5.2%; girls, 4.3%, p>0.05). It was found that 28.5% of the children experienced their first FS between the ages of 18 months and three years old and most of them had an upper respiratory tract infection. The most common practice by parents during the seizure was admission to the nearest emergency room. The recurrence rate for FS was 33.0%.Conclusions:The FS prevalence determined in our study is lower than previous studies in Turkey. It was thought that the advancing healthcare systems in our country might have decreased the FS prevalence within the last eight years in Izmir.

Purpose Despite the fact that socioeconomic and environmental factors of a population are changing over time, there are few studies focusing on the effects of sociodemographic factors on the prevalence of febrile seizures (FS). This study was designed to find out the prevalence of FS and to investigate the effect of socio-cultural and economic factors on this prevalence among the Turkish school children. Methods A school-based, cross-sectional study was conducted in first and second-class children. Data were collected through a questionnaire from the parents who agreed to be involved in the study. The survey had questions about some socioeconomic and demographic features of the children and febrile seizure episodes. Results 3806 children and parent pairs accepted to participate in the survey. Febrile seizure prevalence was 4.8%. It was found that the prevalence of FS was significantly associated with the chronic illnesses of a child that requires continuous medication, developmental delay of a child, NICU history, gestational hypertension history of a mother, and lower educational level of a mother. Recurrence of FS was observed in 32.9% of children. Children whose first FS was seen below the 39 °C had 1.9 times more recurrence risk. Conclusion FS prevalence rate has declined from 9.7% to 4.3% in our study population within ten years. It was thought that advancing healthcare systems in our country might be decreased the prevalence. Our study enabled us to find out sociodemographic risk factors of FS, but further studies are needed in order to confirm the effect of sociodemographic factors on FS prevalence.

BackgroundDespite the high prevalence of infantile colic, the pathogenesis remains incompletely understood. Cortisol and melatonin hormones affect gastrointestinal system development in several ways, and interestingly, both cortisol and melatonin's circadian rhythms begin around the 3rd month in which infantile colic symptoms start to decrease. We hypothesized that infantile colic might associate with desynchronization of normal circadian rhythms of these hormones. In this study, we aimed to investigate the role of melatonin and cortisol in the pathogenesis of infantile colic.MethodsPatients who were diagnosed as infantile colic according to Wessel's rule of three were enrolled in the colic group. We measured the saliva melatonin and cortisol levels of colic group and control group infants. In both groups, the saliva samples were taken in mornings and at evenings, at the time of diagnosis and 6th month.ResultsFifty-five infants finished the study. Melatonin circadian rhythm developed earlier in the control group than the infantile colic group in our study. We found no significant difference between the daily mean cortisol levels. However, infants with colic had flatter daily cortisol slope than controls which pointed out the probability that they had a less clearly defined cortisol rhythm than infants without colic.ConclusionsWe found an association between melatonin levels and infantile colic. However, more research is needed to fully understand the role of hypothalamic-pituitary-adrenalaxis and hormone's role on infantile colic physiopathology.

Lungs are one of most metastatic areas for primitive neuroectodermal tumor (PNET), however primary pulmonary PNET is extremely rare. Here we present a case of a 58-year-old male patient with a tumor in the right lung that originated from the lung but not from chest wall. Patient was diagnosed with PNET following histological and immunohistochemical examination of CT-guided percutaneous tru-cut needle biopsy and no distant metastasis were detected in PET-CT scan. As advised recently in published literature, surgical resection following neoadjuvant chemotherapy protocol is preferred in the treatment of our patient as it has better success of complete resection leading to higher 5-year survival rates. Although primary pulmonary PNET is uncommon, it should be taken into account and complete surgical resection should be aimed as treatment to achieve higher survival rates.

Background: We aim to determine the relationships among vitamin B12, folic acid, homocysteine (Hcy), and methylenetetrahydrofolatereductase (MTHFR) C677T polymorphism, as well as the clinical importance of these relationships, in patients using valproic acid (VPA), carbamazepine (CBZ), and levetiracetam (LEV) as monotherapy and polytherapy. Methods: We enrolled 37 patients on VPA, 30 on CBZ, 31 on LEV, 30 on multidrug therapy, and 60 control subjects. We compared the levels of vitamin B12, folic acid, Hcy and polymorphism. Results: Vitamin B12 was low in patients on CBZ (p=0.02) and in combined CBZ and VPA (p=0.02). B12 was low in combined CBZ and VPA (p=0.05). In patients without polymorphism, Hcy was high on VPA (p=0.02), and folic acid was the low on CBZ (0.005). In patients with polymorphism, vitamin B12 was low on CBZ (p=0.02), and folic acid was low on VPA (p=0.04). Vitamin B12 was low in combined CBZ and VPA (p=0.05). Conclusions: Vitamin B12 therapy is necessary on CBZ and on combined CBZ and VPA. VPA should not be used in the presence of other thrombophilic risk factors because of hyperhomocysteinemia. Polytherapy does not increase hyperhomocysteinemia risk in comparison to monotherapy. Vitamin B12, folic acid, Hcy do not effect on seizure frequency.

WOS:000504064500002 Objective: The aims of the study were to: (i) screen for PTSD among subjects older than 15 years old living in the Ercis-Van region nine months after the earthquake; and (ii) examine the socio-demographic, clinical and trauma-related factors of PTSD diagnosis. Method: At the time of the earthquakes, the population of Ercis-Van region was 1,050,000. We selected 1498 participants in these areas: 996 from Van and 502 from Ercis, centers using a stratified sampling frame (Kish design). Demographic information, trauma related experiences and past psychiatric history was obtained via socio-demographic survey. The PTSD module of the Composite International Diagnostic Interview (CIDI), along with depression, dysthymia, social anxiety disorder, obsessive compulsive disorder, generalized anxiety disorder structured interview modules were used to directly elicit clinical information. Results: We found that PTSD was prevalent 35.5% among Van earthquake survivors. Analysis of binary Logistic regression showed risk factors, which included some trauma related losses, pre and post traumatic experiences. These risk factors are being female, having depression, loosing any family members or relatives, being unemployed, having serious familial conflicts, severe financial loss, and temporary relocation. Discussion: Our results indicate that in addition to being women, having depression, trauma related losses, like previous traumatic experiences, some pre and post traumatic risk factors are important for development of PTSD. Therefore, after the traumatic event, community based interventions should be structured based on these pre and post disaster risk factors. ÖZET Amaç: Bu çalışmanın amaçları; (i) Van Depreminden dokuz ay sonra Van-Erciş bölgesinde yaşayan 15 yaş üstüı bireylerde Travma Sonrası Stres Bozukluğunu taramak ve (ii) Travma Sonrası Stres Bozukluğu tanısını yordayabilecek sosyodemografik, klinik ve travmayla ilişkili etmenleri gözden geçirmektir. Yöntem: Deprem sırasında Van ve Erciş bölgelerinde 1,050,000 kişi yaşamakta idi. Araştırmaya tabakalandırılmış örneklemle (Kish Metodu) Van’dan 996, Erciş’ten 502 kişi alınmıştır. Sosyodemografik veri formu aracılığıyla demografik bilgiler, travmayla ilişkili deneyimler ve geçmiş psikiyatrik öykü elde edilmiştir. Klinik bilgiler için Uluslararası Bileşik Tanı Görüşmesi/ Composite International Diagnostic Interview (CIDI)’nin TSSB, depresyon, distimi, sosyal anksiyete bozukluğu, obsesif kompulsif bozukluk ve yaygın anksiyete bozukluğu modülleri kullanılmıştır. Bulgular: Van depremi sonrasında deprem mağdurlarında TSSB oranını %35.5 olarak bulduk. Binary Lojistik regresyon analizi travmayla ilişkili , travma öncesi ve sonrası kimi etmenleri TSSB için risk faktörü olarak göstermiştir. Bu faktörler kadın olmak, depresyonda olmak, aile üyelerini veya bir yakınını kaybetmek, ciddi sağlık ve barınma sorunları yaşamak, işsiz,olmak, aile içi ciddi çatışmaların varlığı, ciddi finansal zorluk, geçici yer değiştirmedir. Sonuç: Araştırmamızın sonuçları depresyon, kadın cinsiyet, travmayla ilişkili kayıplar yaşamaya ek olarak geçmiş travmatik deneyimler gibi travma öncesi ve sonrası kişide oluşan risk faktörlerinin TSSB gelişimde önemli olduğunu göstermiştir. Bu nedenle travma sonrası topluma dayalı çalışmalar afet öncesi ve sonrası risk faktörlerine dayandırılarak yapılandırılmalıdır.

Amaç: Çocuk acil kliniğimize başvuran kronik hastalığı olan çocukların bakım verenlerinin epidemiyolojik özelliklerini ve bakım verme yükünü araştırıp, bunlar arasındaki ilişkiyi değerlendirmeyi amaçladık.Gereç ve Yöntem: 18 yaş altında, kronik hastalık nedeni ile takip edilen hastaların bakım verenleri çalışmaya dahil edildi. Bakım verenlerin yaşadığı stresi değerlendirmek amacıyla Zarit Bakım Verme Yükü Ölçeği (ZBYÖ) kullanıldı. Bulgular: ZBYÖ puanları 24–83 arasında değişmekte olup ortalama 47,64±15,31 olarak bulundu. Bakım yükü ile bakım verenlerin yaş grupları incelendiğinde, >40 yaş olan 21 bakım verenin 13’ü (p= 0,001) ağır derecede yüke, 18-25 yaş arasındaki 25 bakım verenin 14’ü istatistiksel anlamlı olarak (p= 0,001) hafif derecede yüke sahip idi. Bakım verenlerin gelir düzeyi incelendiğinde; ağır derecede yüke sahip 41 hastanın 19’u istatistiksel anlamlı olarak 10/yıl hastane ziyareti olan 25 hastanın bakım vereninin 16’sı (p= 0,001) istatistiksel anlamlı olarak ağır yüke sahip idi. Sonuç: Bakım verenlerinin bakım verme yüklerini belirlemek, yaşadıkları güçlükleri tanımlamak, gerekli sosyal ve ekonomik desteği sağlamak, yaşam kalitelerini artırmak ve hastaların daha kaliteli hizmet alması için gereklidir. Anahtar Kelimeler: Bakım veren; bakım verme yükü; kronik hastalık

Congenital rubella syndrome is a transplacental infection that may cause serious devastating damage in the fetus, including intrauterine growth retardation, cataracts, patent ductus arteriosus, hearing loss, microcephaly, thrombocytopenia, and hepatitis. Rubella vaccine is administered for preventing congenital rubella syndrome. It is suggested that patients must be screened for pregnancy before vaccination and should be informed regarding contraception for 3 months after vaccination. Herein, we presented a 1-month-old boy to whom rubella vaccine was administered. After performing multiple diagnostic studies to exclude other liver disorders, the patient, who had high liver enzymes, was diagnosed with congenital rubella infection by his mother's history and positive anti-rubella IgM. His liver enzymes returned to normal at 2 months of age of the follow-up period. Negative anti-rubella IgM was revealed at 6 months of age. As a result, when rubella vaccine is administered in pregnancy, high liver enzymes might occur without other congenital rubella syndrome signs in newborns. Infants who are borne by pregnant women with rubella vaccination should be monitored.

Objective: Overweight and obesity comprise one of the most serious public health problems of the 21st century. The aim of this study is to investigate the incidence of overweight and obesity in an age group of 3-6 years in central towns of Izmir Metropolitan City and to examine the risk factors of obesity.

Objective This study aimed to assess the possible association of high breast milk sodium levels with postpartum depression and anxiety. Methods A total of 150 mothers and their healthy, exclusively breastfed newborns aged 8 to 15 days were recruited. Mothers were asked to complete scales for evaluation of postnatal depression and anxiety following an interview for consent and sociodemographic data collection. Breast milk samples were obtained to measure sodium and potassium (K) levels. Results Forty-nine mothers had higher than expected breast milk Na concentrations and a high Na/K ratio. These mothers scored significantly higher on the scales of postnatal depression and state anxiety ( P = 0.018 and P = 0.048, respectively). Conclusions This study shows that compared to normal breast milk Na levels and Na/K ratio, high breast milk Na and high Na/K ratio, with possible serious consequences in infants, are associated with maternal depressive and anxious symptoms in the postpartum period.

Objective: Our aims were to investigate the prevalence of PTSD, depression, anxiety-related disorders, and dissociative symptomotology, and to assess the risk factors for development of psychopathology among children and adolescents after the 2011 Van earthquake in Turkey. Methods: The screening was conducted among 738 participants at 6 months post-earthquake using the CPTSD–Reaction Index, State and Trait Anxiety Inventory for Children, Screen for Child Anxiety Related Emotional Disorders, Child Depression Inventory, Childhood Anxiety Sensitivity Index, Metacognitions Questionnaire for Children, and Adolescent Dissociative Experiences Scale. Results: Less than half (40.69% of) of the participants reported severe levels of PTSD symptoms, 53.04% were at greater risk for developing an anxiety-related disorder, 37.70% met the criteria for clinical depression, and 36.73% revealed pathological levels of dissociative symptomotology. State–trait anxiety, and anxiety sensitivity were significant antecedents of psychopathology. Conclusion: We concluded that anxiety sensitivity is a significant risk factor in various types of psychopathology, but metacognitions seem to have a limited utility in accounting for poor psychological outcomes in young survivors of earthquake.

Variations in diurnal preferences for activity and sleep have long been classified as morning and evening chronotypes. Although morning and evening-types do not differ in sleep architecture, earlier studies have revealed the association between eveningness and psychopathology. However, most of these works had been conducted only with patient samples. Additionally, previous research has also discovered that morning-types have a healthier lifestyle than evening-types. Therefore, the aim of the present study was to assess the associations between chronotypes and general well-being and psychopathology levels in practically healthy young adults, whose physical and mental health were both examined precisely prior to the research, for the first time in the literature. We found that morning-type individuals have significantly better health conditions than evening-types. And, participants exhibiting a tendency to evening-type were more prone to develop psychological symptoms than subjects exhibiting morning-type chronobiological characteristics. Mental health professionals should be aware that eveningness may be a risk factor for mental and physical health even in currently well young adults.

Objective: Breastmilk is a unique source of nutrients for healthy growth and development. The most important factors affecting breastfeeding are mothers' breastfeeding self-efficacy, and breastfeeding success. The aim of this study is to examine the factors affecting breastfeeding self-efficacy and success of mothers', and the relationship between breastfeeding self-efficacy and success.

Objective: In this study, levels of sodium (Na) and sodium/potassium ratio (Na/K), which are considered as indicators of successful lactation, and their relationships with the mothers and their babies' sociodemographic features, psychosocial risk factors of mothers and their adult type attachment styles were aimed to be investigated.

The melatonin as the pineal gland's secretory product is implicated in the pathophysiology of migraine. Melatonin has critical functions in human physiology, and research underscores the importance of melatonin in circadian rhythm, sleep, and mood regulation. Clinical observations have indicated that migraine attacks have a seasonal, menstrual, and circadian timing, suggesting that chronobiological mechanisms and their alterations may causally involve in the etiology of the disease. However, the topic has received relatively little attention in the migraine literature. Associations between melatonin, circadian preference, sleep, and mood states were investigated in the current study. Fifty-five patients (47 females and 8 males) were compared to 57 gender and age-matched control subjects (40 females and 17 males). A socio-demographical questionnaire, the Beck Depression Inventory, Beck Anxiety Inventory (BAI), Pittsburgh Sleep Quality Index (PSQI), Profile of Mood States (POMS), and Morningness-Eveningness Questionnaire were administered to volunteers. Blood samples were taken from all participants at about 1:00 AM in an unlit room not to hamper melatonin secretion, and blood melatonin levels were measured using quantitative ELISA test. In comparison with controls, melatonin levels were significantly lower among migraine patients. Migraineurs reported significantly greater scores on the BAI, confusion-bewilderment subscale of the POMS, and total and sleep latency subscale of the PSQI. Migraine patients who had nausea during the migraine attacks and who reported bouts relevant to certain food consumption, such as cheese or chocolate, had significantly lower levels of melatonin. Contrarily, groups did not reveal statistically substantial difference in circadian preferences.

Objective. Seasonality is one of the most interesting but still elusive issue in suicide research. Linkages of seasonality in suicides to possible contributors such as gender, type of method used, and climatic factors have received attention in different cultures. We aimed at evaluating seasonal trends in suicidal behaviour according to demographic characteristics, reasons for self-destructive behaviour and means preferred in suicide. Methods. Our aim was to assess the seasonal variation in self-destructive behaviour in terms of completed and attempted suicides in a 3-year time period from 2008 to 2010 in Van, Turkey. A total of 1448 cases were registered over a 3-year time period in the city. Seasonal deviations in demographic characteristics, reasons for suicide, and methods of suicide were evaluated. Results. Seasonal distribution of both completed and attempted suicides by gender did not significantly deviate. On the other hand, we found a significant decline in self-destructive behaviours among those who were single and student in the spring. We found a peak in self-destructive behaviours in the autumn among Individuals who suffer from psychological problems. Conclusions. Subjects with psychological difficulties were more prone to commit suicide in autumn. Seasonal differences in methods of suicide used by suicidal subjects were not significant.

The predictive value of interpersonal schemas, perfectionism, and thought action-fusion in obsessive-compulsive disorder Objective: Cognitive vulnerability factors are central in the etiology of obsessive-compulsive disorder. Nosological classifications among symptom clusters have been developed to enable the understanding of possible mechanisms underlying obsessive compulsive symptoms. Previous researchers have emphasized that perfectionist attitudes and thought action-fusion link to increase in obsessive compulsive symptom severity in clinical and nonclinical samples. However, multi-dimensional relations between obsessive compulsive symptoms and vulnerability factors such as interpersonal schemas have received little attention. This study examined connections between cognitive vulnerability factors and obsessive-compulsive symptoms. Method: The data collected from 263 university students. Associations between variables were analyzed by using structural equation modeling. Results: The results of the study indicated that dysfunctional interpersonal schemas were the most hazardous factors that predict perfectionist attitudes, thought action-fusion, and symptom severity in obsessive compulsive disorder. Washing and precision were the final manifestation symptoms mediated by checking. Maladaptive interpersonal schemas, perfectionist attitudes, and thought action-fusion were all vulnerability agents in the development of obsessive compulsive symptoms. Checking played a prominent role in exacerbation of obsessive –compulsive symptoms. Conclusion: Onset and maintenance of obsessive-compulsive disorder is a multidimensional process. Negativistic interpersonal beliefs seem to be an important risk factor. Findings are discussed in the light of current theoretical considerations.

Background Many patients who remit fully/partially or recover from an episode of major depression continue to suffer from sleep problems, mainly insomnia. Our study assesses the frequency and types of ongoing or re-emerging subjective insomnia symptoms and their relationship to subsequent depressive relapse or recurrence in a group of full/partial remitters or recoverers. Method Sixty patients, 18 to 65 years of age, with current MDD defined using DSM-IV-TR criteria were participated in the study. They began a 24-week course of open-label acute plus continuation phase treatment mainly with SSRIs. Maintenance treatment was not planned for not affecting natural relapse or recurrence rates. All participants were evaluated by CGI-S, BDI, HAMD-17, PSQI, and ISI at weeks 0, 4, 12, 24, and 52. Results Majority of the participants (83.33%) had subjective sleep disturbance, insomnia prior to relapse or recurrence. Repeated measures ANOVA was used to evaluate changes in scores of depression and sleep scales over time between recurred (N = 12) and non-recurred groups (N = 48). Differences between means were calculated with post hoc Bonferroni comparison test. The changes in scores of entire clinical scales over time between recurred and non-recurred groups were statistically significant. Limitations The limitations of this study include the use of a relatively small, mostly young female sample and the lack of an objective sleep measure to corroborate self-report scales. Conclusions Early recognition and treatment of disturbances of the sleep–wake cycle may be important for treatment and prevention of recurrence of depression.

Objective: The aim of the present study was to investigate the relationship between nightmares and acute myocardial infarction (AMI) occurring during sleep, and also to evaluate the influence of several related factors. Method: The sample comprised AMI patients who had been admitted to the coronary care unit. The patients were grouped into two categories; the asleep-AMI group consisted of 36 patients who had the onset of symptoms of AMI during sleep, and the awake-AMI group included 183 patients who had AMI while they were awake. The sleep quality and dream anxiety for the 1-month interval before AMI were assessed with Pittsburgh Sleep Quality Index (PSQI) and Van Dream Anxiety Scale (VDAS), respectively. Results: Asleep-AMI patients reported significantly poorer subjective sleep quality, significantly higher global PSQI scores, and displayed significantly higher nightmare frequency, difficulty in falling asleep after a nightmare, higher autonomic hyperactivity, dream recall frequency, daytime anxiety, psychological problems, and higher global dream anxiety scores than awake-AMI patients. Conclusion: The present study suggests that sleep anxiety and related emotions are associated with AMI during sleep. (Psychosomatics 2011; 52:544-549)

Morning and evening-type individuals differ on a number of psychological and biological variables. In this study, we aimed to investigate the relationship between sleep quality, dream anxiety, and chronotypes. A sample of 264 university students, aged between 17 and 26 years, completed the Morningness-Eveningness Questionnaire, the Pittsburgh Sleep Quality Index, and the Van Dream Anxiety Scale for assessing nightmare frequency and the dream anxiety caused by frightening dreams. Main findings indicated that evening-type individuals were significantly more likely to suffer from poor sleep quality, daytime dysfunction, nightmares, and nightmare-related disturbances as compared to either intermediate- or morning-type individuals. Previous studies have pointed out the possible connections of irregular sleep-wake habits and circadian dysregulation with a tendency to reveal eveningness chronotypical characteristics. Current findings suggest that evening-type individuals are more prone to experience psychologically deteriorating nightmares and sleep-related anxiety. Poor sleep quality is also a significant antecedent of dream anxiety after controlling for age and gender.

Population-based studies indicate the risk of acute myocardial infarction (AMI) is greatest in the morning, during the initial hours of diurnal activity. The aim of this pilot study was to determine whether chronotype, i.e., morningness and eveningness, impacts AMI onset time. The sample comprised 63 morning- and 40 evening-type patients who were classified by the Horne-Ostberg Morningness-Eveningness Questionnaire (MEQ) in the hospital after experiencing the AMI. The average wake-up and bed times of morning types were similar to 2 h earlier than evening types. Although the lag in time between waking up from nighttime sleep and AMI onset during the day did not differ between the two chronotypes, the actual clock-hour time of the peak in the 24-h AMI pattern did. The peak in AMI of morning types occurred between 06:01 and 12:00 h and that of the evening types between 12:01 and 18:00 h. Although the results of this small sample pilot study suggest one's chronotype influences the clock time of AMI onset, larger scale studies, which also include assessment of 24-h patterning of events in neither types, must be conducted before concluding the potential influence of chronotype on the timing of AMI onset. (Author correspondence: dryavuzselvi@yahoo.com).

Objective. The present study examined whether obsessive beliefs change over time in the OCD patients receiving selective serotonin reuptake inhibitors (SSRIs) and the impact of obsessive beliefs in treatment response. Methods. In the first part of a two-stage study comparing the efficacy of antipsychotics as augmenting agent in SSRI-resistant OCD patients, 57 patients were interviewed with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Hamilton Depression Rating Scale (HDRS) and Obsessive Beliefs Questionnaire-44 (OBQ-44) before and after 12-week of SSRI treatment period. Results. All OBQ-44 subscale scores significantly decreased with SSRI treatment. The mean changes in OBQ-44 Importance and Control of Intrusive Thoughts (I/CT) subscale and HDRS total scores of responders were significantly higher than those of SSRI-resistant patients. The baseline OBQ-44 P/C and Y-BOCS obsession subscale scores significantly predicted the treatment resistance in a logistic regression model. Conclusions. The alleviation of negative mood by SSRIs may help the sufferer to disengage from dysfunctional appraisals. Since individuals with highly obsessive beliefs about P/C are more likely to be resistant to SSRI treatment, the treatment of OCD can be made more effective when focusing on altering appraisals about P/C.

Morning- and evening-type individuals differ on a number of psychological and biological variables. There has been increasing interest in the relationship between chronotype and personality traits. The aim of this study was to investigate the relationship between impulsivity and chronotype in suicide attempters. Eighty-nine suicide attempters were included in the study, and systematic information on suicide attempts was recorded. The Morningness-Eveningness Questionnaire was applied to determine chronotype, and attempter impulsivity was measured by the total score of the Barratt Impulsiveness Scale. Significant differences between chronotype and impulsivity scores were found. Evening-type subjects reported significantly higher impulsivity scores than both neither- and morning-types. A significant association between chronotype and type of suicide attempt was detected. The largest proportion of violent suicide attempters were evening-type subjects. Violent suicide attempters also reported significantly higher impulsivity scores than nonviolent attempters. Previous studies have pointed out possible relations between eveningness and impulsivity. Current findings suggest that eveningness may be a risk factor for violent suicide attempts by increasing impulsivity. (Author correspondence: dryavuzselvi@yahoo.com).

Objective: This study aimed to assess the symptoms of psychopathology caused by the shift-work and to evaluate their impact on the quality of life. Method: Forty-two nurses working at daytime and 45 nurses working at the night shift were evaluated with Symptom Checklist-90-R (SCL-90-R) and Short Form 36 (SF-36) for assessing general psychiatric symptoms and quality of life. Results: Shift-work nurses reported significantly higher somatization, obsessive-compulsive, interpersonal sensitivity, anxiety, paranoid ideation and global severity index scores than daytime nurses. Significant differences were not found in the depression, hostility, phobic anxiety and psychoticism scores. Shift-work nurses also reported significantly worse scores on pain and physical function compared with daytime nurses. Conclusion: In our study, shift-work was shown to be a potential risk factor for increased psychiatric morbidity and low quality of life among nurses. Therefore, adjusting the work schedule with the potential problems of the workers may improve their life quality.

Research interest concerning associations between sleep characteristics and suicidality in psychopathology has been growing. However, possible linkages of suicidality to sleep characteristics in terms of sleep quality and chronotypes among depressive patients have not been well documented. In the current study, the authors investigated the possible effects of sleep quality and chronotype on the severity of depressive symptoms and suicide risk in patients with depressive disorder and healthy controls. The study was conducted on 80 patients clinically diagnosed with major depression and 80 healthy subjects who were demographically matched with the patient group. All participants completed a questionnaire package containing self-report measures, including the Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), Morningness-Eveningness Questionnaire (MEQ), and Suicide Ideation Scale (SIS), and subjects were interviewed with the suicidality section of the Mini-International Neuropsychiatric Interview (MINI). Results are as follows: (a) logistic regression analyses revealed that poor sleep quality and depression symptom severity significantly predicted onset of major depression; (b) morningness-type circadian rhythm may play as a significant relief factor after onset of major depression; (c) sleep variables of chronotype and sleep quality did not significantly predict suicide ideation after controlling for depressive symptoms in the major depression group; and (d) suicide ideation and poor sleep quality were antecedents of depression symptom severity in patients with major depression, and in healthy controls. Findings are discussed under the theoretical assumptions concerning possible relations between chronotype, sleep quality, depression, and suicidality. (Author correspondence: dryavuzselvi@yahoo.com).

The aim of this study is to investigate a school within the context of school development processes. In the study, semi-structured interviews were used and the head-teacher, a teacher, and a member of (PTA) were interviewed. Findings of the study suggest that there are many internal and external factors that affect school's capacity for change and development. It was concluded that the school culture, leadership and collaboration with insider and outsider stakeholders significantly contribute to whole school development. It is recommended that schools should adopt a development plan and work with all parties to keep up with change in education.© 2010 Published by Elsevier Ltd.