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Pek çok farklı literatür çalışması göstermektedir ki; insan gelişiminin en önemli aşamalarından biri olan çocukluk çağı sürecinde, kişinin anne babasıyla kurmuş olduğu iletişim ve onlardan aldığını düşündüğü ebeveynlik, yetişkinlik dönemindeki tavır, davranış ve tutumlarına etki etmektedir. Bu etkileşimin kişinin ebeveynlik tutumlarını yordaması da kaçınılmaz olacaktır. Araştırmanın amacı anne ebeveynlerin kendi anne ret-kabullerinin, ebeveynlik tutumu üzerine etkisinin incelenmesidir. Bu amaç kapsamında araştırmaya 2-6 yaş arasında çocuğu bulunan 493 anne dahil edildi. Araştırmada anket yöntemi kullanılmıştır. Verilerin elde dilmesi için Demografik Bilgi Formu, Ebeveyn Tutum Ölçeği (ETÖ) ve Yetişkin Ebeveyn Kabul-Ret Ölçeği (EKRÖ) kullanıldı. Katılımcıların ebeveyn kabul düzeyinin yüksek olduğu görülmüştür. Katılımcıların demokratik tutumları yüksek, otoriter tutumları düşük, aşırı koruyucu ve izin verici tutumları orta düzeyde bulundu. Katılımcıların EKRÖ alt boyutları ve ETÖ alt boyut puanları gelir durumuna göre değiştiği sonucuna ulaşılmıştır. Sonuç olarak araştırmada katılımcı annelerin ret kabul düzeyleri ile ebeveynlik tutumları arasında düşük düzeyde ilişki bulunmuştur.

Multidisipliner bir alan olan adli bilimler, adaletin toplum ve toplumu olusturan bireyler arasinda esit olarak saglanabilirligine hizmet eden saglik, fen ve sosyal bilimler gibi egitsel, teknolojik ve pozitif bilimler toplulugunu kapsar. Bu bilimsel alanda teorik ve uygulamanin birbirleriyle ortusen ve ortusmeyen bircok noktasi bulunmaktadir. Teorik bilgilerin havada ucustugu cagimizda bu bilgilerin adli bilimlerin uygulama alanina yansimasi cok onemlidir. Adli tip, hukuk, psikoloji, sosyal hizmet, cocuk gelisimi, kriminoloji, antropoloji, ogretmenlik, medya, polis ve jandarma gibi guvenlik birimlerini de iceren toplumun cok genis bir alaninda birlikte calismaya ve uretmeye gereksinim bulunuyor. Egitim ve ogretimin en onemli parcasini deneyimlerimiz ve uygulama alanlari yani “olgu temelli” yaklasim belirliyor. Olgu, bilgiyi dogru kullanim, gelisim ve degisimin temeli olma yaninda egitim ve ogretimin ayrilmaz bir parcasidir. Bu paradigma ile elinizde tutugunuz “Olgularla Adli Tip & Adli Bilimler” kitabinin tip fakultesi ogrencileri, adli tip asistanlari, adli tip uzmanlari, adli bilimlerin farkli alanlarinda lisans, yuksek lisans ve doktora ogrencileri basta olmak uzere tip, hukuk, psikoloji, dis hekimligi, kriminoloji, sosyal hizmet, antropolojigibi cok cesitli adli bilimler alaninda calisanlara en son guncel literatur bilgileri yaninda olgularla yeni perspektifler de kazandiracagi kanisindayim. Kitabin okuyucuya multidisipliner bir yaklasim yaninda evrensel etik ilkelere de bagli bir adli tip/adli bilimler yaklasimi kazandirmasini diliyorum. Kitabin yaziminda katkilari olan bolum yazari hocalarimiza, meslektaslarimiza, asistanlarimiza, ogrencilerimize ve destek ve katkilari icin Akademisyen Yayinevi sahibi Yasin Dilmen’e sonsuz tesekkur ediyorum. Bilimselligin ve liyakatin gelecegin adli bilimlerini insa etmede tek gercek oldugu bilinciyle kitabin alanimizin bilimsel niteligini daha da yukseklere tasinmasina aracilik etmesi dilegiyle… Prof. Dr. Halis DOKGOZ Mersin, 2020

Previous studies have demonstrated that clusterin ( CLU), which is also known as apolipoprotein J, is involved in the pathogenesis of Alzheimer disease (AD). In this study, we investigated the association between rs2279590, rs11136000, and rs9331888 single-nucleotide polymorphisms (SNPs) in CLU and apolipoprotein E ( APOE) genotypes in a cohort of Turkish patients with late-onset AD (LOAD). There were 183 patients with LOAD and 154 healthy controls included in the study. The CLU and APOE polymorphisms were genotyped using the LightSNiP assay. The “GG” genotype of rs9331888 was significantly more frequent in patients with LOAD. The “CC” genotype of the SNP was significantly more frequent in controls. The rs9331888 “GG” genotype in patients and the “CC” genotype in controls were significantly higher in non-∊4 allele carriers of APOE. The haplotype analysis showed the CLU “GCG” haplotype was a risk haplotype. Our findings indicate the rs9331888 SNP of CLU is associated with LOAD independent of APOE.

Vitamin D-3 is a neurosteroid that mediates its effects via the vitamin D receptor (VDR). The VDR gene is located on chromosome 12q13 and consists of 9 exons. VDR contains the DNA-binding site encoded by exons 2 and 3 and the ligand-binding site encoded by exons 4 - 9. Our earlier study showed that the ApaI polymorphic site of the VDR gene is associated with late-onset Alzheimer-s disease (AD). Here, we investigated the association between additional polymorphisms of the VDR gene and AD using the same samples. Two single nucleotide polymorphisms (SNPs) in intron 8 (BsmI and Tru9I polymorphisms) and one in exon 2 (FokI polymorphism) of the VDR gene were examined in up to 108 AD patients and 115 age-matched controls. Genotypes were determined with polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) methods. Haplotype analysis also included the previously studied polymorphic sites that were recognized by TaqI (in exon 9) and ApaI (in intron 8) restriction enzymes. There was no significant difference between AD patients and controls when their genotypes for BsmI, Tru9I and FokI polymorphic sites were compared. However, the frequency of -TaubF- haplotype (alleles of TaqI, ApaI, Tru9I, BsmI and FokI, respectively), which was determined by analyzing 5 polymorphisms together, was significantly higher in the AD patient group, suggesting that this haplotype is a risk factor in AD. Our results point out a possible link between AD and certain VDR polymorphisms and indicate that individuals with these polymorphisms might be vulnerable to AD. İstanbul Üniversitesi

Background/Aims: The polymorphism (rs1800587) in the 5′-flanking regulatory region at –889 of the interleukin-1α gene has been shown to be associated with inflammatory diseases and Alzheimer’s disease (AD). The aim of the current study is to determine whether there is an association between the promoter region polymorphism of the interleukin-1α gene and late-onset AD in a cohort of Turkish patients. Methods: One hundred and four subjects with dementia of the Alzheimer type and 103 age-matched controls were genotyped according to the PCR with confronting two-pair primers method. Results: Although the distribution of genotypes did not significantly differ (p = 0.107), the difference between allelic frequency was nearly significant according to a χ2 test (p = 0.05) when the controls and patients were compared. Conclusion: Our results showed that there is no association between the –889 C/T transition on the interleukin-1α gene and late-onset AD in the Turkish population.

Presenilin-1 is known to contribute to the pathogenesis of Alzheimer's disease. The association of an intronic polymorphism (rs165932) of the presenilin-1 gene with late-onset Alzheimer's disease has been documented. However, contradicting results have been shown in different populations. The aim of the current study is to determine whether there is an association between the intronic polymorphism of the presenilin-1 gene and late-onset Alzheimer's disease in a cohort of Turkish patients. One hundred and seven participants with dementia of the Alzheimer type and 106 age-matched controls were genotyped according to BamH I restriction site in intron 8 of the presenilin-1 gene. The distribution of genotypes and alleles did not significantly differ according to χ 2 test (P = .52, P = .32, respectively), when the control and patients were compared. Consequently, our results showed that the 1/1 genotype does not increase the risk of developing late-onset Alzheimer's disease in the Turkish population.

Turkey is a country where a young population is dominant. However, 6 percent of the population was older than 65 in 2005, approximately 4-5 million people. The percentage of the elderly is expected to double by 2020. Along with this expectation, geriatric psychiatry is a rapidly developing area in Turkey. In this paper, the political approaches of the Turkish government to the elderly population and their mental health, the advantages and limitations related to aging are discussed in detail from a developing country perspective.

The case of a 35-year-old female patient who was diagnosed as schizophrenia treated with psychotrophic drugs nearly for 15 years is presented here. After the disease was diagnosed, the patient quit her university education and began to live inactively far from her social environment, usually spending lazy time at home. During this period, due to either the effects of drugs which have to be used on hormones affecting appetite and body weight or her decreased physical activity, her body weight increased by nearly 30 kg. Anthropometric measurements, biochemical parameters and food diaries were evaluated at the beginning of the nutritional counseling and then repeated periodically. Upon obtaining biochemical findings, collaboration with other units started. The patient was educated on nourishing healthy and controlling body weight, also to bring about lasting behavioral changes. At the beginning of the therapy, among the biochemical measurements, insulin resistance was defined and metformin treatment was begun. Metformin therapy contributed to the patient's adaptation to the diet and improved glucose tolerance. In this way, it was possible to cope with the insulin resistance caused by anti-psychotic pharmacotherapy (clozapine) and the obesity which had developed as a result of clozapine. During the 18-month therapy the patient lost 27 kg, her body fat was reduced by 10% (18 kg) and BMI returned to normal levels. It is known that, many medications used in psychiatric disorders affect appetite and body weight. As seen in our patient metformin therapy causes weight loss and decreases insulin resistance. Both the illness and the medications used for treatment could affect the hormones which play a part in controlling body weight and the cytokines, as a result could change food preference and eating behavior which ultimately pave the way to obesity.

In this article we report the first series of Turkish inpatients with late-onset psychosis, and describe our 9-year experience at the only inpatient geriatric psychiatry department in Turkey. Among 420 patients hospitalized between 1993 and 2002, 27 were psychotic. In this group, eight patients were diagnosed as having late-onset schizophrenia (LOS) and six very-late-onset schizophrenia-like psychosis (VLOSLP). Five patients had early-onset schizophrenia and eight had delusional disorder. Females were more frequently seen in the group with LOS and the group with VLOSLP. Except for one patient with LOS, all patients with VLOSLP and LOS had paranoid psychosis. Nihilistic delusions, delusions of poverty or guilt, thought withdrawal, thought insertion, and thought broadcasting were not seen in any of the patients. Additionally, none of the LOS or VLOSLP patients showed erotomanic delusions. Grandiose and mystic delusions were not seen in those with VLOSLP. Treatment results and antipsychotic dosages at discharge were similar to those in previous reports from other cultures.

Alzheimer's disease (AD) and associated behavioral and psychological symptoms of dementia (BPSD) are already recognized as major medical problems of the aging population in the western world. Although BPSD are not yet regarded as a major issue in many developing countries, such as Turkey, these symptoms will undoubtedly become a management issue in the future. Because BPSD contribute most to caregiver burden and interfere with patients' well being, they are predictors of early institutionalization (Hamel et al., 1990). This article reviews the literature on BPSD in eastern and southeastern Europe and the Middle East.

The purpose of this study was to examine the Geriatric Depression Scale (GDS) translated into Turkish for its reliability, discriminant validity, and factor structure in a sample of 276 community-dwelling elderly and 30 patients with major depression. One item (Item 5) was discovered to have conceptual difficulty for Turkish elderly and was transformed to negative form. Item 2 was transformed to positive form to keep the number of positive and negative items equal to that in the original GDS. A reasonable time stability with 1-week interval (r:.74) and a high level of internal consistency (α = .91) were observed. Student's t test resulted in a significant discriminant validity for the scale total score. Factor study with principal component analysis and varimax rotation gave rise to a structure with seven factors. Results of the same analysis with two factors were found to be easier to interpret. The first factor was composed of 19 items reflecting “depressive affect and thought content.” The other 11 items representing “decrease in motivation and cognitive functions” loaded in the second factor. In conclusion, the Turkish GDS was found to have reasonable time reliability, high internal consistency, and discriminant validity for Turkish elderly. Its two-factor structure can be used as an informative instrument for epidemiological studies, reflecting two main dimensions of depression in the elderly.

Corynebacterium species other than Corynebacterium diphtheriae rarely cause infections in human but rather reside in flora, however they have been reported to cause opportunistic infections in both immunocompromised and immunecompetent patients. Here we report for the first time a case of an elderly female patient presenting with a fatal urosepsis caused by a recently defined pathogen, Corynebacterium riegelii, identified on second day after patient hospitalization leading to a progressive worsening and death of the patient on 6th day.

Background: Few studies have looked at healthcare professionals' knowledge of and attitudes to later life sexuality in both Western and Eastern cultures. Here we examine the attitudes and knowledge of Turkish medical doctors toward sexuality in older people. Method: Eighty-seven doctors, from various specialties, who were directly involved in the care of older people, were contacted by post and asked to complete the Turkish version of the Aging Sexual Knowledge and Attitudes Scale (ASKAS). Results: A majority of physicians indicated that they had limited information and knowledge regarding sexual health issues in older people (69%). Although a small percentage (14.5%) reported that they "always" discuss sexuality and sexual problems with older patients, the majority (69%) indicated that they "sometimes" raise questions about sexuality with these patients. A high percentage (81%) stated that they would be helpful and receptive should an elderly patient initiate a discussion about sexual issues. Most participants (77%) thought that the patient's gender was of no importance when taking a sexual history. Overall, the responses to ASKAS showed that physicians had limited knowledge but their attitude was positive toward sexuality in the elderly. Female physicians had less knowledge than males and had more negative attitudes toward sexuality in this age group. Total and knowledge subscale scores of ASKAS showed that older physicians had more knowledge than younger physicians but similar attitudes. A comparison of the knowledge and attitude scores of psychiatrists, surgeons and non-surgeons showed no significant difference among the three groups. Conclusion: This study identified a low level of awareness of later life sexuality among Turkish medical doctors. These findings identify a need to improve the education and training of doctors at both undergraduate and postgraduate levels to enable them to provide better sexual health care to older people.

OBJECTIVES: The aim of this study was to investigate serum leptin, adiponectin and paraoxonase1 levels in adult females receiving pharmacotherapy for various psychiatric disorders. METHODS: The study group consisted of 32 obese females (mean age 40.53 ± 11.00 years, mean body mass index 35.44 ± 5.33 kg/m2) who were receiving treatment for psychiatric disorders, and the control group included 22 obese females (mean age 35.95 ± 9.16 years, mean body mass index 30.78 ± 3.33 kg/m2) who were free of psychiatric disorders. Analyses were performed using a bioelectrical impedance device. Fasting blood samples were obtained for complete blood count and various biochemical tests, including determination of leptin, adiponectin and paraoxonase1 activity. RESULTS: Body mass index, waist and hip circumference, body fat percentage, fasting blood glucose, insulin, glycosylated hemoglobin, homeostasis model assesment of insulin resistance, alanine transaminase, aspartate tarnsaminase, and leptin levels were significantly higher in the study group than in controls. Although body weight was positively correlated with leptin levels in both groups, body weight was negatively correlated with adiponectin levels in the control group and positively correlated with adiponectin levels in the study group. In the study group, body mass index and hip circumference correlated positively with leptin levels, hip circumference correlated positively with adiponectin levels, and waist to hip ratio correlated positively with paraoxonase levels. In the control group, body mass index as well as waist and hip circumferences were positively correlated with leptin levels. Weight, body mass index, and hip circumference were also negatively correlated with the adiponectin/leptin ratio in the control group. CONCLUSION: This study indicates a higher risk for obesity-related disorders, particularly metabolic syndrome, diabetes and cardiovascular disease, in patients treated with psychiatric drugs., Ozenoglu, A.; Department of Psychiatry, Cerrahpasa Medical Faculty, University of Istanbul, Istanbul, Turkey; email: aliyeozenoglu@yahoo.com

Vitamin D(3) is known to be involved in neuroprotection and exert its neuroprotective effects by modulating neuronal calcium homeostasis and production of neurotrophins. The single nucleotide polymorphisms (SNP) in vitamin D receptor (VDR) gene which can influence the affinity of vitamin D(3) to its receptor may be related to neurodegenerative diseases and neuronal damage by altering the vitamin D-mediated pathways. In this study, our aim was to determine whether there is an association between VDR gene and late-onset Alzheimer's disease (AD) in order to see if vitamin D contributes to AD or not. One hundred and four cases of dementia of Alzheimer type and 109 age-matched controls were genotyped according to ApaI (a: + restriction site and A: no restriction site) and TaqI (t: + restriction site and T: no restriction site) sites in intron 8 and exon 9 of the ligand-binding site of VDR gene. When the controls and patients were compared for their ApaI genotypes, the frequency of the patients with Aa genotype was significantly higher than the frequency of the healthy individuals with the same genotype (p = 0.008, chi(2) = 9.577, OR = 2.30). Thus, the "Aa" genotype may increase the risk of developing AD 2.3 times when compared with the "AA" genotype. On the other hand, the "AT" haplotype was significantly higher in controls (p = 0.006) indicating a protective role of the "AT" haplotype in AD. Consequently, this study provides evidence for a possible link between AD and vitamin D.

We aimed to study the relation between sex hormones and depression among elderly women. The study was carried out on 74 volunteered female subjects above 60 years of age. Each subject was asked to fulfill the geriatric depression scale (GDS) questionnaire and further evaluated for clinical depression by a psychiatrist using the DSM IV diagnostic criteria. For statistical analysis, subjects were later divided in two groups, according to the presence of clinical depression. Cognitive functions were assessed with the standardized mini mental test (SMMT). Disability in the activities of daily living was assessed with instrumental activities of daily living (IADL) scale. Plasma levels of estrogen, testosterone, progesterone, and dehydroepiandrosterone sulfate (DHEA-S) were measured with chemiluminescent methods, and plasma levels of androstenedione were measured with radioimmunoassay. Among 74 subjects, 34 (39%) had clinical depression. Age, number of years spent in education, SMMT scores, and IADL scores did not differ between the depressive and non-depressive groups. Plasma sex hormone levels were not found to be different between the two groups.

Reliability and validity of the Mini Mental State Examination in differentiating mild dementia from normal controls in Turkish population.The Standardized Mini Mental State Examination (SMMSE) and its instruction were translated into Turkish. A total of 212 subjects with mean age of 77 +/- 6, were recruited for the study. 71 were diagnosed to be demented and 141 were evaluated as normal controls. The scale total score was analysed for discriminant validity using Student's t-test. Sensitivity, specificity, positive and negative predictive values and kappa score were calculated for all of the scores between 18 and 29. Kappa value was calculated for the comparison of the dementia diagnosis between the two investigators using the best cut off score obtained in the analysis above.Statistical analysis revealed that the Turkish version of the SMMSE has high discriminant validity and interrater reliability in the diagnosis of mild dementia. The cut off score 23/24 was found to have the highest sensitivity (0.91), specificity (0.95), positive and negative predictive values (0.90 and 0.95) and kappa score (0.86). Interrater reliability analysis showed high correlation (r:0.99) and kappa value (0.92).The results of this study showed that the Turkish version of the SMMSE has high reliability and validity for the diagnosis of mild dementia in Turkish population.

In this study, the relationship between lipid profiles of sera and apolipoprotein E (apo E) gene polymorphism was investigated in 35 patients with Alzheimer's disease (AD) and 29 healthy people. Apo E genotypes and allele frequencies of the AD patient group were: apo E2/3, 2 (5.7 percent); apo E2/4, 1 (2.9 percent); apo E3/3, 26 (74.3 percent); apo E3/4, 5 (14.3 percent); apo E4/4, 1 (2.9 percent); epsilon 2, 3(4.2 percent); epsilon 3, 59 (84.2 percent); epsilon 4, 8 (11.4 percent). The healthy group's apo E genotypes and allele frequencies were: apo E2/3, 1 (3.4 percent); apo E3/3, 27 (93.1 percent); apo E3/4, 1 (3.4 percent); epsilon 2, 1 (1.7 percent); epsilon 3, 56 (96.5 percent); epsilon 4, 1 (1.7 percent). In Alzheimer's cases, epsilon 4 allele frequencies increased significantly as compared to the healthy group (p0.05). When the effects of the apo E isoforms on lipid profiles were evaluated, a relationship between apo E epsilon 4 allele and high total levels of serum cholesterol was found, whereas of apo E epsilon 2 allele was associated with the low total cholesterol of serum, although the difference was not statistically significant (p0.05). This study confirms the association of apo E epsilon 4 allele with lipid profiles in AD patients.

Studying behavioral and psychological symptoms of dementia (BPSD) across cultures allows the identification of similarities and differences that may be useful to determine the best approach to managing these symptoms in different populations. Although BPSD are not yet regarded as a main health issue in many developing countries, such as Turkey, these symptoms will undoubtedly become a management issue in the near future. There are also racial, ethnic, and cultural differences in dementia caregiving. There are some cross-national studies that use similar methodology in AD, and very few studies on BPSD that include developing countries or migrant populations. Although the BPSD constitute one of the major domains of symptomatology of age-associated dementia, Turkish family practitioners, residents in psychiatry and neurology, and even general psychiatrists and neurologists do not in general have sufficient experience to evaluate BPSD. Family members in Turkey are more likely to report behavioral and affective disturbances rather than memory problems. Caregivers in our community may underreport BPSD because of the fear the patient will be labeled or institutionalized, their need to maintain an acceptable social facade, their desire not to relinquish the caregiver role, and their religious values. Cultural influences must be considered in the studies of BPSD. Western countries should be able to compare results with different cultures. Therefore, joint studies are important.

The clinical history of a 33-year-old man suffering from an autoerythrocyte sensitization syndrome due to hemoglobin sensitivity is presented.

Both apolipoprotein-E (apo-E) epsilon 4 allele and angiotensin-converting enzyme (ACE) deletion (D) polymorphism have been associated with a high risk for coronary heart disease. Increased frequency of the epsilon 4 allele has also been reported in patients with late-onset of familial and sporadic Alzheimer's disease (AD). The primary aim of this study is to examine the possible relationship between the ACE gene polymorphism and AD. The second aim of this study is to explore the relation of the ACE and apo-E genotypes with AD. Polymerase chain reaction (PCR), restriction fragment length polymorphism (RFLP), and agarose gel electrophoresis techniques were used to determine the apo-E and ACE genotypes. The frequencies of ACE D and ACE insertion (I) allele among AD patients and controls were 55.7 percent versus 44.2 percent and 51.7 versus 48.2 percent, respectively. Apo-E allele frequencies in the AD group for epsilon 2, epsilon 3 and epsilon 4 were, 1.7 percent, 96.5 percent, and 1.7 percent, respectively. The apo-E allele frequencies of healthy groups for epsilon 2, epsilon 3 and epsilon 4 were 1 percent, 56 percent, and 1.7 percent, respectively. In conclusion ACE D and apo epsilon 4 allele were found to be more frequent in patients with Alzheimer's disease than in the control group.