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INTRODUCTION[|]In this study, it was aimed to investigate the sociodemographic and clinical features that may be related to antipsychotic polypharmacy and to discuss the causes and effects of this condition. [¤]METHODS[|]The records of the cases followed up at the psychotic disorders outpatient clinic were analyzed retrospectively. Sociodemographic and disease related clinical features, Clinical Global Impression Scale (CGI) Severity of Illness and Advers Events in their last applications were evaluated.[¤]RESULTS[|]The most common diagnosis is schizophrenia with a rate of 63.6% (n = 150). It was determined that 76.7% (n = 181) of 236 patients included in the study were using at least two antipsychotic drugs, %64.8 (n=153) were using long acting parenteral antipsychotics. When comparing antipsychotic polypharmacy and monotherapy patients;statistically significant difference was found in terms of age, gender, onset age of disease, history of electroconvulsive therapy (ECT), long termparenteral antipsychotic use, number of hospitalizations and duration of their last hospitalization, Clinical Global Impression Scale severity of illness and advers events scores.[¤]DISCUSSION AND CONCLUSION[|]Although there is insufficient data on the efficacy and safety of antipsychotic polypharmacy, it appears that it is preferred in practice far above the recommendations of treatment guidelines.It seems important to understand the causes of this situation, and to make adjustments in the practices and guidelines of clinicians.Medical, social and economic consequences caused by antipsychotic polypharmacyshould be considered.[¤]

Objective: In this study it is aimed to compare the theory of mind skills and executive functions in bipolar disorder patients and their first degree relatives with controls, and to demonstrate the relationship between executive functions and theory of mind. Method: 30 patients with euthymic bipolar I disorder, their first degree relatives, and 30 healthy controls were included in the study. Sociodemographic data form, Hamilton Depression Rating Scale, Young Mania Rating Scale, Wechsler Adults Intelligence Test were applied to all participants; Wisconsin Card Sorting Test, Stroop Test, Trail Making Test A and B, and Digit Span Test were applied to evaluate the executive functions; Reading the Mind in the Eyes Test, Hinting Task and Faux Pas Test were applied to evaluate the theory of mind skills. Results: There was not any significant difference between the groups in terms of theory of mind, although total scores were seen from bad to good in bipolar patients, first degree relatives and controls respectively. Patient group had significantly lower performance in Trail Making Test A, and DigitSpan Test inverse number scores. As the severity of disease increased, cognitive functions and the theory of mind were seen to be worsened. The theory of mind was related to executive functions. Discussion: In conclusion, we did not find significant losses in terms of theory of mind in bipolar patients and their first degree relatives. But bipolar patients had a deficiency in attention, psychomotor speed and verbal working memory; and theory of mind was related to executive functions. © 2019 ANP Publishing. All rights reserved.

The effects of traumatic life events and losses can be passed down from generation to generation through intergenerational and/or transgenerational transmission. The genosociogram is a family tree study enriched with important life events and connections. With the Genosoyogram study, it is possible to trace unresolved and incomplete traumas and ensure their completion. It is known that traumas have an important role in the etiopathogenesis of somatic symptom disorder. In this case report, it is aimed to present the results of the genosociogram study of 22 patients with somatic symptom disorder. Most of the patients had traumatic lives during childhood. It was determined that approximately one third of the patients had similar somatic symptom history, and 2 patients had anniversary reactions. It can be said that in patients with somatic symptom disorder, the genosoyogram study enables a detailed examination of the trauma and its effects, and to recognize the burdens transferred from past generations. It is also possible to see and remember positive elements such as strength, hope and commitment to life transferred from our ancestors. Studies using comprehensive and standardized measurement tools are needed on this subject. © 2020 The Author(s).

The aim of this study is to examine the effect of psychodrama group study on students' procrastination behaviour. The research was done as a single group quasi-experimental, pre-test post-test study design. The research sample consisted of 14 nursing students who volunteered and fulfilled the criteria of the study. A Personal Information Form and Tuckman Procrastination Scale used in collecting the data. The Tuckman Procrastination Scale scores of the students were decreased significantly (p

Schizophrenia and schizoaffective disorder are chronic and debilitating psychiatric disorders. The present study was designed to determine DNA damage in patients with schizophrenia and schizoaffective disorder to assess the roles of oxidative metabolism and DNA repair mechanisms in this process, to assess the contribution of drugs, and thus to demonstrate the differences between schizophrenia and schizoaffective disorder. Thirty schizophrenia and 30 schizoaffective disorder patients, each having at least five years of disease history, aged between 18 and 60 years with no physical or neurological diseases, and 30 healthy volunteers participated in the study. Psychometric scales were applied, and 5 ml of blood was taken from all participants. The DNA damage was measured in lymphocytes by the comet assay method; the total oxidative parameters by ELISA; OGG1 and NEIL1 gene expressions by real-time PCR; and the role of drugs by in vitro assays. The most important finding in this study was that patients with schizophrenia had significantly greater DNA damage than schizoaffective disorder patients and the controls. This study also provides evidence of high oxidative stress statuses and inadequate DNA repair capacities in patients with schizophrenia. Moreover, psychotropic drugs did not induce any DNA damage to the lymphocytes according to in vitro analyses. The use of clozapine and adequate repair processes of the patients were the decisive factors in the prevention of DNA damage. The results of this study provide a reexamination of schizoaffective disorder within the schizophrenia spectrum and indicate that schizoaffective disorder may be considered a different diagnostic category. © 2018 Elsevier B.V.

Objective: In this study, we aimed to adapt the Structured Clinical Interview for DSM-5-ClinicianVersion into Turkish and to demonstrate its reliability. Method: A total of 185 patients, both inpatient and outpatient, from two different university hospitals were included. Training sessions on the features and use of SCID-5/CV were held before the data collection. During the study, in order to test the diagnostic agreement and accuracy, two psychiatrists remained present at the evaluation of each participant; alternatively being interviewer and the observer. Cohen's kappa coefficient for inter-rater reliability was calculated for every diagnostic category. Results: The patient group had a mean age of 37.2 (±13.5) years and 55.7% were female. The education status was as follows: 2.7% were illiterate, 1.7% literate with no primary education, 33% had primary education, 23.8% had secondary education and 38.9% had higher education. The calculated kappa value showed excellent agreement for schizophrenia (κ=0.93), bipolar disorder (κ=0.96), major depressive disorder (κ=0.89), dysthymic disorder (κ=0.82), alcohol use disorder (κ=0.96), panic disorder (κ=0.84), agoraphobia (κ=0.85), social anxiety disorder (κ=0.95), generalized anxiety disorder (κ=0.89), obsessive compulsive disorder (κ=0.87), posttraumatic stress disorder (κ=0.89), adult attention deficit and hyperactivity disorder (κ=1.00), specific phobias (κ=0.82) and very good agreement with adjustment disorder (κ=0.78) and somatic symptom disorder (κ=0.65). Conclusion: Similar to the past SCID versions, kappa values were found to be quite high and all were statistically significant. The Turkish version of SCID-5/ CV can be reliably used in both clinical practice and clinical studies. © 2019, Turkish Association of Nervous and Mental Health.

Amaç: Bu çalışmada bipolar bozukluk hastaları ve birinciderece yakınlarında zihin kuramı becerileri ve yürütücüişlevlerinde bozulma olup olmadığı ve aralarındakiilişkinin araştırılması amaçlanmıştır. Yöntem: ÇalışmayaDSM-IV’e göre tanı konmuş 30 Ötimik Bipolar I bozukluklu hasta, bu hastaların birinci derece yakınları ve 30sağlıklı gönüllü katılmıştır. Tüm katılımcılara sosyodemografik veri formu, Hamilton Depresyon Ölçeği, YoungMani Ölçeği, Wechsler Erişkinler İçin Zeka Testiuygulanmış; yürütücü işlevleri ve dikkati değerlendirmekiçin Wisconsin Kart Eşleme Testi, Stroop Testi, İz SürmeTesti A ve B, Sayı Dizisi Testi; zihin kuramı yeteneklerinideğerlendirmek için ise Gözler Testi, İmayı Anlama Testive Pot Kırmayı Farketme Testi uygulanmıştır. Bulgular:Gruplar arasında zihin kuramı açısından anlamlı farksaptanmamıştır ancak toplam zihin kuramı puanlarınınbipolar hasta, hasta yakını ve kontrol grubu sırasınıizlediği görülmüştür. Dikkat ve Yürütücü işlevlerde isehasta grubunun İz Sürme Testi-A ve Sayı Dizileri Testi terssayı puanlarında anlamlı düşüklük görülmüştür. Zihinkuramı ile yürütücü işlevler arasında korelasyonlar tespitedilmiştir. Ayrıca hastalık yükü arttıkça bilişsel işlevlerinve zihin kuramının kötüleştiği görülmüştür. Sonuç: Buçalışmada, bipolar hastalarının ve yakınlarının zihinkuramı açısından anlamlı kayıplar yaşamadığı; ancakbipolar hastalarda özellikle dikkat ve psikomotor hızdaazalma, sözel çalışan bellek alanında bozulmalar olduğu;zihin kuramının yürütücü işlevlerle ilişkili olduğugörülmektedir.

Amaç: Primer motivasyon kaybı olarak adlandırılan apati yaşlılık dönemidepresyonunda erişkinlik dönemine göre daha sık izlenmektedir.Apatinin depresif belirti şiddeti ve bilişsel işlevlerle ilişkili olduğu, apativarlığının nörobilişsel bozulma açısından yordayıcı olabileceği ilerisürülmektedir. Bu çalışmada, yaşlılık dönemi depresyonunda apatidüzeyleri ile depresif belirti şiddeti ve bilişsel işlevler arasındaki ilişkininincelenmesi amaçlanmıştır.Yöntem: Çalışma, 60 yaş ve üzerinde majör depresif bozukluk (MDB)tanısı konulan 40 hasta ve 40 sağlıklı kontrol ile gerçekleştirilmiştir.Katılımcılara sosyodemografik veri formu, yapılandırılmış psikiyatrikgörüşme (SCID-I), Hamilton Depresyon Değerlendirme Ölçeği (HAM-D),Hamilton Anksiyete Değerlendirme Ölçeği (HAM-A), MontgomeryAsberg Depresyon Değerlendirme Ölçeği (MADRS), Standardize MiniMental Test (SMMT), Montreal Bilişsel Değerlendirme Ölçeği (MoCA),Apati Değerlendirme Ölçeği (ADÖ) ve Sheehan Yeti Yitimi Ölçeği (SYYÖ)uygulanmıştır.Bulgular: Çalışmamızda, yaşlı MDB grubunda HAM-D, HAM-A, MADRSve ADÖ ölçek puanları sağlıklı kontrol grubuna göre yüksek bulunmuştur.MDB grubunda ADÖ puanları ile depresif belirti şiddeti arasında pozitifkorelasyon, ADÖ puanları ile bilişsel işlevler arasında negatif yöndekorelasyon tespit edilmiştir. MDB grubunda SMMT ve MoCA puanlarısağlıklı kontrol grubuna göre düşük bulunmuştur. Yaşlı MDB grubundaözellikle yönelim, görsel/mekansal işlevler, bellek ve lisan alanlarındadüşük performans gözlenmiştir. MDB grubunda işlevselliğin kontrolgrubuna göre düşük olduğu, apati düzeyi arttıkça işlevselliğin azaldığıtespit edilmiştir.Sonuç: Sonuçlarımız, yaşlılık dönemi depresyonunda apati düzeylerininsağlıklı kontrol grubuna göre yüksek olduğunu göstermektedir. Yaşlılıkdöneminde majör depresif bozuklukta bilişsel işlevler olumsuz olaraketkilenmekte, apati düzeyi ile depresif belirti şiddeti, bilişsel işlevlerdekive işlevsellikteki bozulma ilişkili görünmektedir.

Objective: Previous studies suggest that the level of clinical insight in schizophrenia patients is related to working memory functions. However, these studies were not specifically concerned with the components of working memory and had not focused in detail on working memory functions. For this reason, the current study investigated the relationship between clinical insight and working memory components in patients with schizophrenia and schizoaffective disorder. Method: The patient group was evaluated by using the Scale for Assessment of Negative Symptoms, the Scale for Assessment of Positive Symptoms, and the Scale to Assess Unawareness of Mental Disorder to measure clinical insight. Moreover, all participants underwent a "Situation Awareness" test in order to measure working memory functions. Based on published data, the first stage of this test was accepted to measure the "visual spatial sketchpad" component of working memory, and the second stage was accepted to measure the "episodic buffer" (bound information storage) component. The functions of these components were measured separately as top-down and bottom-up cognitive processes. Results: The episodic buffer function (managed by the bottom-up cognitive process) was related with clinical insight. This relationship also continued after correcting for the effect of positive symptoms on insight. The patients performed worse than the controls in terms of visual spatial sketchpad function, which was managed by both top-down and bottom-up cognitive processes. The patients performed worse than the controls in terms of both top-down and bottom-up cognitive processes and visual spatial sketchpad function. Furthermore, the patients were also worse than the controls in terms of episodic buffer function (managed by top-down cognitive processes). Conclusion: Clinical insight may be associated with binding function (associated with episodic buffer function) managed by bottom-up cognitive processes in patients with schizophrenia and schizoaffective disorder. Further studies are necessary to confirm this novel finding. © 2019, Turkish Association of Nervous and Mental Health.

Introduction Apathy which is known as loss of primary motivation is observed more frequently in elderly depression in comparison with younger adults. It is put forth that apathy is related with depressive symptom severity and cognitive functions, that the existence of apathy may be a predictor of neurocognitive impairment. The objective of this study was to examine the apathy levels in elderly patients with major depression as well as the relationship between depressive symptom severity and cognitive functions. Methods The study was carried out with 40 major depressive disorder patients (MDD) aged 60 and above, 40 healthy controls aged 60 and above. Sociodemographic data form, structured psychiatric interview (SCID-I), Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Montgomery-Asberg Depression Rating Scale (MADRS), Standardized Mini Mental State Examination (SMMSE), Montreal Cognitive Assessment Scale (MoCA), Apathy Evaluation Scale (AES) and Sheehan Disability Scale (SDS) were applied to the participants. Results In our study, HAM-D, HAM-A and MADRS scale scores of MDD group was determined to be higher in comparison with those of the healthy control group. A positive correlation was determined in the MDD groups between the AES scores and depressive symptom severity, whereas a negative correlation was determined between the AES scores and cognitive functions. The SMMSE and MoCA scores of the geriatric MDD group were determined to be lower in comparison with healthy control group. Low performance was observed in the geriatric MDD group especially in the fields of orientation, visual/spatial functions, memory and language. Functionality was found to be lower in MDB group than in the control group, and functionality decreased as the level of apathy increased. Conclusion Our results indicate that the apathy levels in geriatric depression are higher in comparison with the control group. Cognitive functions are affected adversely in geriatric patients in major depressive disorder, depressive symptom severity, impairment in cognitive functions and functionality are observed to be related with apathy level.

Introduction: Metacognitive constructs have shown promise in explaining the symptoms of Obsessive-Compulsive Disorder (OCD). Few studies have examined the role of metacognitions in symptom dimensions of OCD, despite mounting clinical, neuropsychological and imaging evidence for the distinctiveness of these dimensions. Methods: Metacognitions were assessed using the Metacognitions Questionnaire (MCQ-30) in 51 participants with DSM IV OCD and 46 healthy controls. The Maudsley Obsessional Compulsive Inventory (MOCI) was used to quantify symptom dimensions, along with the Hamilton Anxiety Rating Scale (HAM-A) for anxiety, and Hamilton Depression Rating Scale (HAM-D) for depression. Results: Individuals with OCD differed from healthy controls on beliefs of uncontrollability and danger when depression and anxiety were controlled for. Correlations between metacognitive beliefs and obsessive-compulsive symptom dimensions were largely similar across the OCD and healthy control groups. Hierarchical regression showed that need to control thoughts contributed to checking, cleaning and rumination symptoms; cognitive self-consciousness to symptoms of slowness; uncontrollability and danger to doubt symptoms; positive beliefs to checking symptoms. Conclusions: Specific associations between metacognitive variables and the different symptom dimensions of OCD are evident, however, severity of anxiety and depression also contribute to these associations. © 2018 by Turkish Association of Neuropsychiatry.

Objectives: The aim of this study was to investigate medial prefrontal cortex neurochemical metabolite levels in patients with schizophrenia and schizoaffective disorder. Method: The subjects comprised 15 patients with schizophrenia (SCH), 15 patients with schizoaffective disorder (SAD), and 15 healthy controls. Levels of N-acetyl aspartate (NAA), choline-containing compounds (Cho), creatine-containing compounds (Cr), and myo-inositol (myo-I) were measured in the medial prefrontal cortex (mPFC) using 1H-MRS. Results: Differences were detected in NAA, Cho, Cr, and myo-I levels among the groups. In schizophrenic patients, the left and right mPFC NAA levels and left mPFC Cho level were found to be lower, compared to the control group. In patients with schizoaffective disorder, left and right mPFC NAA, Cho, Cr, and myo-I levels were found to be lower compared to the control group. No difference was detected in mPFC neurochemical metabolite levels between schizophrenia and schizoaffective disorder patients. Conclusion: In this stud were found that in schizophrenia and schizoaffective disorder, NAA and Cho levels are reduced. Consequently, in these two diseases, neuronal activity and neuronal integrity are impaired in the medial prefrontal region, and there are defects in membrane phospholipid metabolism. In addition, the decreases in Cr and myo-I levels in schizoaffective disorder patients point to abnormalities in energy metabolism and glial cells in the medial prefrontal region.

Object: Psychodrama enables a formulation related with the factors causing depression while contributing to the patients to acquire insight and get well. With psychodrama group psychotherapy applications, the patients can benefit from the treating factors of group study as well as the specific technique and interventions of psychodrama. The objective in this study was to summarize the psychodrama psychotherapy application process on depression patients with antidepressant use and to discuss the points which are thought to contribute to recuperation. Methods: A total of 15 patients with mild-moderate level of depression participated in the study and 9 patients completed the group process. In addition to medications, a total of 16 sessions of group psychotherapy and psychodrama studies were applied on the patients with 3 hours of each per week. The severity of depression was assessed via Hamilton Depression Rating Scale (HAM-D17). Expectations of the patients from group therapy were asked during the first session and a common list was prepared using the recorded responses. It was evaluated in the final session whether these expectations have been met or not. Results: The initial HAM-D17 score average of the patients was determined as 13.33 (±2.39), whereas it was determined as 5.88 (±4.01) at the end of the treatment. A statistically significant decrease was determined in the severity of depressive symptoms after treatment (z=2.677, p=0.007, Wilcoxon test). The expectations of the patients from group psychotherapy and psychodrama were revised. It was determined at the end of the treatment that anger control of the patients increased, fears and irritability decreased, that they received support from the group and that they understood themselves better. Discussion: Our results lead us to think that psychodrama group psychotherapy contributes to recovery in depression treatment. Psychodrama has contributed to understanding which factors have played a role in the formation of depression and the changing of these factors realized by the patient as well. © 2017 ANP Publishing. All rights reserved.

The aim of this study was to compare schizoaffective disorder, bipolar disorder and schizophrenia based on 1H-MRS metabolite values in dorsolateral prefrontal cortex and executive functions. The subjects comprised 15 patients with bipolar disorder type I (BD), 15 with schizophrenia (SCH), 15 with schizoaffective disorder (SAD) and 15 healthy controls. We performed proton magnetic resonance spectroscopy ( 1H-MRS) of the dorsolateral prefrontal cortex (DLPFC) bilaterally. Levels of N-acetyl aspartate (NAA), choline-containing compounds (Cho) and creatine-containing compounds (Cr) were measured in the DLPFC using 1H-MRS. We administered the Wisconsin Card Sorting Test (WCST) and the Stroop Test (ST) to evaluate executive functions. The SAD, BD and SCH patients had lower levels of NAA than the control group. The SAD and BD patients had low levels of Cho compared to the control group. The left DLPFC Cr levels in all of the patient groups and the right DLPFC Cr levels in the BD and SAD groups were lower than in the control group. The levels of NAA Cho and Cr were not related to executive functions and attention performance. Cr level were related to attention processes, only in SCH. Our results indicate that NAA levels are reduced in schizoaffective disorder, bipolar disorder and schizophrenia, but the reduction in the levels of NAA is not a distinctive feature among these three illnesses. Schizoaffective and bipolar disorders have similar features related to the levels of compounds containing Cho and Cr. This similarity may be related to these illnesses both having an affective basis. © 2012 Elsevier Inc.

Objective: The aim of this study was to investigate cognitive function in individuals with schizophrenia and schizoaffective disorder. Method: Research participants included 48 outpatients with a diagnosis of schizophrenia, 35 outpatients with schizoaffective disorder, and 48 non-patients from the community. Scale for Assessment of Positive Symptoms (SAPS), Scale for Assessment of Negative Symptoms (SANS), and Brief Psychiatric Rating Scale (BPRS) were applied to the patients. Neuropsychological evaluation included Wisconsin Card Sorting Test (WCST) for executive functions, Verbal Memory Processes Test (VMPT) for verbal memory and Stroop Test (ST) for attention tasks. Results: There were significant differences among the groups in the number of categories completed, number of perseverative error, percentage of perseverative error, number of conceptual level responses and percentage of conceptual level responses in WCST; time diffrence in Stroop test; score of learning, score of maximum learning and long term memory-recall in VMPT. A post hoc analysis (Turkey) was performed. It was determined that there was no difference between schizoaffective and schizophrenia patients on neuropsyhological tasks. However, schizoaffective and schizophrenia patients had significantly poorer performance than control group on neuropsychological tests. Conclusion: Our study show that cognitive functions in patients with schizoaffective disorder and schizophrenia are similar and that they are both impaired compared with healthy controls.

Objective To investigate the effects of hysterectomy and/or oophorectomy on sexual satisfaction. Methods Forty sexually active women underwent a hysterectomy and/or oophorectomy, for benign gynecological diseases. Patients were interviewed 15 days prior to their operation and again in the 3rd and 6th months after the surgical procedure. Depressive symptoms, anxiety symptoms and sexual satisfaction were measured by the Hamilton Depression Rating Scale, the Hamilton Anxiety Scale and the Golombock Rust Inventory of Sexual Satisfaction (GRISS), respectively. Repeated-measures analyses of variance (ANOVA) examined alterations in anxiety, depression and sexual satisfaction. Independent t-test and Mann-Whitney U tests compared the numerical data. Results The women had mild depressive symptoms before the surgery; however, these symptoms lessened between 3 and 6 months after the surgery. Similarly, the level of anxiety symptoms decreased during the postoperative period. Based on the GRISS cut-off point, it was found that the patients had problems in the sub-dimensions of frequency, communication, and avoidance in the pre-operative period. This pre-existing sexual dissatisfaction continued after the surgery, and sensuality and anorgasmia problems increased. Satisfaction, sensuality, avoidance and anorgasmia GRISS scores were significantly higher after the operation than before. Therefore, the patients' sexual satisfaction was decreased after the operation. Conclusions Patients were dissatisfied with frequency and communication, and they had high levels of avoidance before operation. In the postoperative period, sexual dissatisfaction increased. Although depression and anxiety decreased after the operation, we found that hysterectomy and/or oophorectomy had negative effects on sexual satisfaction. © 2011 International Menopause Society.

Amac: Dikkat eksikligi hiperaktivite bozuklugu (DEHB) cocukluk doneminde baslayan ve dikkatsizlik, asiri hareketlilik ve durtusellik gibi temel belirtilerle kendini gosteren bir bozukluktur. Bipola...

Schizophrenia patients with obsessive-compulsive disorder (OCD) may be a subgroup of schizophrenia, and OCD patients with poor insight may show psychotic-like symptoms. The aim of this work is to compare the neuropsychological performance of those patients with schizophrenic patients who do not have OCD symptoms and with OCD patients who have good insight. The sample consisted of 89 patients (16 OCD-schizophrenic patients, 30 non-OCD schizophrenic patients, 30 OCD patients with good insight, 13 OCD patients with poor insight). Neuropsychological evaluation included executive functions, verbal and visual memory and attention tasks. While schizophrenic patients with OCD did not differ from the non-OCD schizophrenia and OCD with poor insight groups on long-term visual and verbal memory performance, they showed poorer performance than the OCD group on long-term Visual and verbal memory tests. Considering executive function, the OCD group with poor insight performed significantly worse than their counterparts with good insight, and the latter group performed better than the schizophrenia patients. The results of this study suggest that the neuropsychological performance of schizophrenia patients with OCD did not differ from that of non-OCD schizophrenic patients, and that OCD patients with poor insight were more likely to share similar cognitive characteristics with the schizophrenia groups. Our results also provide neuropsychological support for the hypothesis that OCD and schizophrenia may be a spectrum disorders. (C) 2007 Elsevier Ireland Ltd. All rights reserved.

Objective: Aim of this study is to investigate the effectiveness of psychodrama therapy in reducing school counsel-ors’ occupational burnout. In addition, the increase in satisfaction with life and the reduction of depressed mood and level of the hopelessness are expected when the occupational burn out is decreased. Methods: Psychodrama therapy was conducted with school counselors, 16 sessions, and four hours in a week. Study was finalized with 14 school counselors who have either psychology or psychological counseling. School counselors are administered to fill the Maslach Burnout Inventory (MBI), The Satisfaction with Life Scale (SLS), Beck Depression Inventory (BDI) and Hopelessness Scale (HS) before and after the study. Additionally a ‘Result Evaluation Form’ containing open ended questions was used. After the study changes in the counseling teachers were evaluated by the comparison of the score of the scales and with the results of the evaluation forms. Results: A statistical significant difference was found between the pretest and posttest scores after the therapy in MBI and SLS. There was no significant difference in, BDI scores and also in HS scores. The SLS’s pretest-post test scores were not significant however; there was a remarkable reduction in the scores. Conclusions: Current findings are discussed with reference to the literature. It was found that psychodrama is an useful technique in reducing occupational burnout. Similar studies in which will include the comparison of counseling group and control group with a larger sample will be beneficial. © 2016, Cukurova University, Faculty of Medicine. All rights reserved.

Introduction: This study aimed to investigate the relationship between levels of depression and anxiety symptoms and quality of life, self-esteem in obesity. Methods: Fifty-two subjects whose Body Mass Index (BMI) is 30 kg/m² and over and 43 control whose BMI is normal were recruited for this study. The socio demographic data form, Hamilton Depression Rating Scale (HAM-D17), Hamilton Anxiety Rating Scale (HAM-A), Quality of Life Scale Short Form (WHOQOL-Brief-TR), Coopersmith Self Esteem Scale (CSES), The Eating Attitudes (EAT), were applied to the participants. Results: In this study most of the patients are women, married, postgraduated and live in urban areas. It was determined to scores of HAM-D17, HAM-A and EAT are higher in obese group than control group; WHOQOL-Brief-TR physical field scores was lower in obese group than control group. CSES scores wasn’t difference between obese and control group. In obese group, there was HAM-D17 and HAM-A scores a negative correlation between quality of life physical field score, negative correlation between CSES score, positive correlation between EAT scale score. There is no correlation between scores of HAM-D17 and HAM-A and BMI. Conclusion: Our results suggest that depressive and anxiety levels are high in induvidual with obesity. They have problems in eating attitudes and their quality of life especially physical field is poor. The psychological symptoms have negative effects on the quality of life, self-esteem, and eating attitudes. Our results suggest that psychiatric support to improving positive effects quality of life and self-esteem in individual with obesity. © 2015 by Turkish Association of Neuropsychiatry.

Objective Patients with obsessive compulsive disorder (OCD) have inferior social functioning compared to healthy controls, but the exact nature of these social deficits, and the underpinning mechanisms, are unknown. We sought to investigate social functioning in patients with OCD by measuring their involuntary/spontaneous processing of social cues using a specifically designed test, which might reveal deficits in these patients that explicit voluntary tasks do not detect. Methods The sample of the study consisted of an OCD group (n = 25) and a control group (n = 26). Both groups performed an adaptation of the Social Distance Judgment Task (SDJT; Jellema et al., 2009), in which participants have to judge the geometrical distance between two human cartoon figures presented on a computer screen. Head/gaze direction and body direction were manipulated to be either compatible, i.e. both directed to the left or to the right (Compatible condition) or incompatible, i.e. body directed toward the observer (frontal view) and head/gaze directed to the left or right (Incompatible condition). Results In the Compatible condition, controls nor OCD patients were influenced by the social cues in their judgments of the geometrical distances. However, in the Incompatible condition, where the attentional cue was more conspicuous, both groups were influenced by the cues, but the controls to a significantly larger extent than the OCD patients. Conclusions This study showed that patients with OCD are less likely, compared to controls, to automatically/spontaneously integrate the other’s direction of attention into their visual percept. This may have resulted in their judgments of the geometrical distances between the agents to be more accurate than those of controls. The suggested impairment in automatically integrating social cues may have important repercussions for the social functioning of OCD patients.

The objective of the present study was to compare brain activation in patients with obsessive-compulsive disorder (OCD) who received pharmacotherapy (selective serotonin reuptake inhibitor (SSRI) or a SSRI-risperidone combination) with that in healthy controls using Tc-99m-hexamethyl propyleneamine oxime (HMPAO) brain single photon emission tomography (SPECT). Twelve OCD patients achieving clinical response (seven SSRI responders, five patients responded to SSRI plus risperidone) underwent post-treatment SPECT scan. The baseline regional cerebral blood flow (rCBF) was significantly reduced in a large part of the cerebral cortex and the left cingulate gyrus in OCD patients compared with controls. After a 50% reduction of the OCD symptoms, bilaterally increased rCBF in the thalamus showed a significant effect of time in both of the patient groups. In the remitted state, although rCBF in the cingulate gyrus did not differ in SSRI responders compared with controls, patients who responded to the combination of SSRI+ risperidone showed significant hypoperfusion in the left anterior cingulate gyrus. SSRI responders had normalized rCBF in the frontal region relative to the control group. Consequently, based on our results, we attribute the observed thalamic rCBF alteration to SSRI treatment. Our results also suggested that brain perfusion changes associated with clinical remission may differ across patient subgroups. (C) 2012 Elsevier Ireland Ltd. All rights reserved.

Past studies have suggested that OCD patients suffer memory impairment on tasks using complex stimuli that require memory for combined elements to be maintained, but not for more simplistic memory tests. We tested this with 42 OCD patients and 42 healthy controls performed a computerized situation awareness task. In addition, participants completed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and Maudsley Obsessive-Compulsive Inventory (MOCI). The OCD patients had poorer accuracy in integration/comprehension and perception levels than controls. There were significant correlations between situational awareness scores (i.e., visuo-spatial monitoring and processing) and Y-BOCS obsession-compulsion and slowness and doubt scores of MOCI in OCD patients. In addition, there were also significant correlations between situational awareness and controlling, cleaning, slowness, rumination and total scores of MOCI in control group. Results indicated that (I) OCD patients have problems of perception, integration, and comprehension of complex visual perceptions; (II) situation awareness deficits associated with severity and prevalence of obsessions and compulsions. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

Amaç: Bu çalışmada, şizofreni ve şizoaffektif bozukluğu olan hastalarda bilişsel işlevlerin araştırılması amaçlanmıştır. Yöntem: Çalışmaya, remisyon dönemindeki 48 şizofreni hastası, 35 şizoaffektif bozukluğu olan hasta ve 48 sağlıklı kontrol alındı. Hastalara, Pozitif Semptomları Değerlendirme Ölçeği (SAPS), Negatif Semptomları Değerlendirme Ölçeği (SANS) ve Kısa Psikiyatrik Değerlendirme Ölçeği (BPRS) uygulandı. Nöropsikolojik değerlendirmede, Wisconsin Kart Eşleme Testi (WKET), Stroop Testi, Sözel Bellek Süreçleri Testleri (SBST) kullanıldı. Bulgular: Gruplar arasında, WKET’de kategori oluşturma, perseveratif hata sayısı, perseveratif hata yüzdesi, kavramsal düzey tepki sayı ve yüzdesi; Stroop testi süre farkı; SBST öğrenme puanı, en yüksek öğrenme puanı, uzun süreli bellek kendiliğinden hatırlama puanları yönünden anlamlı farklılık bulundu. Yapılan post hoc analizlerde; şizofreni ve şizoaffektif bozukluğu bulunan hastaların nöropsikolojik test puanları arasında farklılık olmadığı, her iki hasta grubunun kontrol grubuna göre daha düşük performans gösterdiği tespit edildi. Sonuç: Bu çalışmada, şizoaffektif bozukluk ve şizofreni hastalarının bilişsel işlev düzeylerinin benzer özellik gösterdiği ve sağlıklı kontrol grubuna göre daha düşük olduğu tespit edilmiştir.

Background: Suicidal behavior is one of the most important problems in psychiatric clinics. Several sociodemographic anclinical characteristics may have different effects on suicidal behavior. Aims: To examine the sociodemographic and clinical characteristic: of a sample of 144 suicide attempters admitted to a Turkish emergency clinic for a suicide attempt. Methods: All subjects were interviewee by a consultant psychiatrist. For all individuals, data on DSM-IV psychiatric diagnoses, sociodemo graphic data, Beck's Hopelessnes:Scale (BHS), Becks's Suicidal Ideation Scale (SIS), and Beck's Suicidal Intention Scale (BSIS) were collected. Results: The majority osuicide attempters were females characterized by low educational status and low religious orientation. Drug overdose was the mos common method of suicide attempt and conflict within the family was the most frequent psychological stress factor. Three-quarters o attempters (74.6%) met DSM-IV criteria for at least one psychiatric diagnosis. Of these, 28.5% met criteria for major depressive disorder Suicide attempters with depression tended to be immigrant, urban dwellers with high scores on the suicide intent scale. Conclusions: In the present study, the findings are useful in showing the risk factors related to suicidal behavior. ©2009 Hogrefe & Huber Publishers.

Reelin is an extracellular matrix-associated protein important in the regulation of neuronal migration during cerebral cortical development. Point mutations in the RELN gene have been shown to cause an autosomal recessive human brain malformation termed lissencephaly with cerebellar hypoplasia (LCH). Recent work has raised the possibility that reelin may also play a pathogenic role in other neuropsychiatric disorders. We sought, therefore, to define more precisely the phenotype of RELN gene disruption. To do this, we performed a clinical, radiological, and molecular study of a family in whom multiple individuals carry a chromosomal inversion that disrupts the RELN locus. A 6-year-old girl homozygous for the pericentric inversion 46,XX,inv7(p11.2q22) demonstrated the same clinical features that have been previously described in association with RELN point mutations. The girl's brain magnetic resonance imaging (MRI) findings, including pachygyria and severe cerebellar hypoplasia, were identical to those seen with RELN point mutations. Fluorescence in situ hybridization confirmed that one of the breakpoints of this inversion mapped to within the RELN gene, and Western blotting revealed an absence of detectable serum reelin protein. Several relatives who were heterozygous for this inversion were neurologically normal and had no signs of psychotic illness. Our findings demonstrate the distinctive phenotype of LCH, which is easily distinguishable from other forms of lissencephaly. Although RELN appears to be critical for normal cerebral and cerebellar development, its role, if any, in the pathogenesis of psychiatric disorders remains unclear. © 2006 Wiley-Liss, Inc.

In this study, the psychological effects of single-dose corticosteroids administered to patients who had undergone rhinoplasty were assessed. A total of 30 rhinoplasty patients were included in the study and were randomly assigned to 1 of 2 groups. Preoperatively, patients completed the Bech Rafaelsen Mania Scale and the Beck Depression Inventory. Dexamethasone 10 mg was given intravenously just before surgery to the first group, but no medication was administered to the second group. On the first postoperative day, patients were seen again, and the Bech Rafaelsen Mania Scale and the Beck Depression Inventory were again completed. Periorbital edema and ecchymosis were graded, and psychological well-being was measured on a standard visual analog scale. All patients and physicians were blinded to treatment until the end of the study. Results show that administration of a single-dose of dexamethasone 10 mg caused neither euphoria nor depression. No significant differences were observed between steroid and control groups in terms of patients' psychological well-being. With single-dose dexamethasone, periorbital edema was significantly reduced on the first 2 postoperative days, and upper eyelid ecchymosis was significantly decreased only on the first postoperative day. However, preoperative steroid administration had no influence on ecchymosis of the lower eyelid. The authors conclude that single-dose dexamethasone 10 mg can be used safely to reduce periorbital edema and ecchymosis in rhinoplasty patients. C1 Pamukkale Univ, Fac Med, Dept Otorhinolaryngol, TR-20010 Denizli, Turkey. Pamukkale Univ, Fac Med, Dept Psychiat, TR-20010 Denizli, Turkey. Pamukkale Univ, Fac Med, Dept Plast Reconstruct & Aesthet Surg, TR-20010 Denizli, Turkey.

Amaç: Bu çalışmanın amacı, psikodrama yönelimli bir grup çalışmasının huzurevinde yaşayan yaşlı bireylerde uygulanabilirliğini, psikolojik ve davranışsal sorunlarla başetme becerileri üzerine etkisini araştırmaktır. Yöntem: Huzurevinde kalan, iletişimi bozucu etkiye sahip bedensel ve ciddi ruhsal sorunu olmayan 11 yaşlı gönüllü erkek ile çalışıldı. Araştırmada psikodrama yönelimli 18 grup çalışması yapıldı. Oturumlar haftada bir gün ve her biri 2.5-3 saat olacak şekilde düzenlendi. Onikinci oturumdan itibaren kurumda bakım veren personel grubu da sürece katıldı. Terapistler her oturum için grup gözlemlerini kaydettiler. Anksiyete ve depresyon düzeylerini değerlendirmek amacıyla Geriatrik Depresyon Ölçeği, Hamilton Anksiyete Değerlendirme Ölçeği kullanıldı. Bulgular: Yaşlılarla yapılan psikodramanın kullanıldığı grup çalışmasında ısınmanın geç olması nedeniyle oyunlaştırma ileri oturumlarda gerçekleşti. Grup sürecinde üyelerin spontanlık, yaratıcılık ve empati özelliklerinin arttığı, dolayısıyla başkalarıyla iletişimin, onlara yardım etme davranışının, sorunlarla başetme becerilerinin olumlu anlamda değiştiği, duyguların ve düşüncelerin sözel ifadelerinin giderek arttığı gözlendi. Grupların bitiminde somatik ve toplam anksiyete puanları başlangıca göre belirgin düzeyde azaldı. Sonuç: Bu çalışma, psikodramatik grup çalışmasının yaşlılarda uygulanabilirliğini, psikolojik ve davranışsal alanda iyileşmeye ve hayatın anlamını keşfetmeye yardım edebildiğini göstermiştir.

A significant proportion of cancer patients experience psychiatric morbidity. Potential predictors of psychiatric morbidity include patient disease-related factors and factors relating to the patient's environment. The aim of this study was to investigate the prevalence of psychiatric morbidity and the relationship between the clinical or personal factors, especially psychiatric morbidity, and awareness of cancer diagnosis among a group of Turkish cancer patients. A total of 117 cancer patients were assessed using the Structured Clinical Interview for DSM-IV (SCID), the Hospital and Anxiety Depression Scale (HADS) and the General Health Questionnaire (GHQ). Of these patients, 30% had a psychiatric diagnosis. Adjustment disorders comprised most of the psychiatric diagnoses. Awareness of the diagnosis of cancer, history of previous psychiatric disorders, pain and stress factors were correlated with psychiatric morbidity. Of the 117 patients, 64 (54.7%) were unaware of the diagnosis of cancer. Most of the patients (67.9%) who were considered to be aware of the cancer diagnosis stated that they had guessed their illness from the treatment process or drug adverse effects. Psychiatric morbidity was significantly higher in the patients who knew that they had a cancer diagnosis (P=0.03). These findings suggest that the awareness of cancer diagnosis is related to the presence of psychiatric morbidity. In particular, the understanding of the diagnosis indirectly may be stressful to the patient because it arouses suspicion about the cancer and treatment, and consequently can lead to psychiatric disturbance. In Turkey honest disclosure of the true diagnosis is still not common for cancer patients and it seems to be essential to improve this situation.

Quantitative analysis of the EEG (q-EEG) in patients with obsessive compulsive disorder (OCD) showed a decreased beta and an increased theta power at frontotemporal regions. The patients who had higher scores in doubting test (Maudsley Obsessive Compulsive Questionnaire) and more severely ill patients shared similar q-EEG features. The relative theta powers were significantly increased and alpha powers were significantly decreased in these patients, particularly in the frontotemporal region. It was suggested that the q-EEG may be useful in investigating the OCD patients with heterogeneous characteristics.