Turk Psikiyatri Dergisi最新文献

Objective: The aim of this study is to evaluate the associations between alcohol-cannabis use and forensic/stressful events with the risk of incident clinical psychosis during follow-up.

Method: A community-based sample (n: 2142) was screened for clinical psychosis (schizophrenia and other psychotic disorders, affective disorders with psychotic features) at baseline and follow-up. Thus, incident clinical psychosis cases to develop during follow-up (individuals with no clinical psychosis at the baseline assessment and with clinical psychosis at the follow-up assessment) were detected (n: 27). These cases and the controls who did not report any psychotic symptoms at the follow-up assessment (n: 1691) were compared for exposure to environmental risk factors during follow-up (total n: 1718).

Results: Individuals reporting heavy alcohol drinking or cannabis use during follow-up had significantly higher risk of incident clinical psychosis. The monthly frequency of drinking and cannabis use was also associated with the risk. Higher number of stressful life events exposed predicted higher risk of incident clinical psychosis. The risk of incident clinical psychosis was significantly higher in case of coexistence of two risk factors (heavy drinking, cannabis use, ≥3 stressful events), in comparison with the existence of a single risk factor (17.7 vs. 1.6%, p<0.001).

Conclusion: Heavy drinking, cannabis use, forensic events and stressful events were associated with the risk of incident clinical psychosis. The coexistence of multiple stressful events and disorders related to abuse of alcohol/cannabis should be considered as a warning for the development of clinical psychosis.

Objective: Quality of life and its correlates were studied in two groups of family caregivers of patients with major mental disorders-Schizophrenia (SZ) and Bipolar Affective Disorder (BPAD).

Method: Family caregivers of SZ and BPAD patients were consecutively recruited to the study (n=100 for each group). Caregivers were screened for quality of life (QOL) measures, caregiver burden, symptoms of anxiety and depression, using the World Health Organization Quality of Life Scale (WHOQOL-BREF), the Pai and Kapur Family Burden Interview Schedule (FBIS) and the Hospital Anxiety and Depression Inventory (HADS) respectively.

Results: When compared to the caregivers of the BPAD patients, the caregivers of the SZ patients had lower QOL scores in two out of the 4 WHOQOL-BREF domains (physical and psychological domains) (p=0.001), and higher overall total caregiver burden (p=0.001). On the other hand, caregivers of the BPAD patients had higher levels of depressive symptoms (p=0.001). Increased depressive symptoms were associated with lower QOL for both groups, comprising all WHOQOLBREF domains for BPAD and 3 domains for SZ caregivers. Higher caregiver burden was associated with lower QOL for both groups.

Conclusion: There is a need for intervention and caregiver support for the relatives of patients with bipolar disorder and schizophrenia.

Objective: Implicit affect is a concept distinct from explicit affect as it describes the affect processed by the individual at a preconscious level. The aim of this research is to evaluate the psychometric properties of the Turkish form of the Implicit Positive and Negative Affect Test (IPANAT-TR), originally developed by Quirin et al. (2009a) to measure affect indirectly.

Method: The study data comprised of psychology and sociology students from Ege University, and full-time and part-time employees from public and private organizations in Izmir. A pilot study was carried out with a group of 57 undergraduate students in order to select the artificial words to be used in the scale. Subsequently the scale was sent to a total of 938 participants, comprising 569 students and 369 employees. Test-retest reliability was assessed with 46 participants after a one-week interval and with 55 participants after a four-week interval.

Results: The principal components analysis showed a clear twofactor structure for the IPANAT-TR. The internal consistency scores were 0.92 for Implicit Positive Affect (IPA) and 0.85 for Implicit Negative Affect (INA). The one-week and four-week interval test retest reliability estimates varied between 0.51 and 0.75. The construct validity assessments showed that the expected relationships between the IPANAT-TR and tested constructs were mostly confirmed. The results of measurement invariance analysis showed that the IPANAT-TR has full measurement invariance across employee and student samples.

Conclusion: The results of the reliability, validity and measurement invariance analyses carried out in the current study demonstrated that the IPANAT-TR is a reliable and valid measurement instrument to assess implicit affect.

Objective: Designated Acts for issues related to mental health are in force in many countries throughout the world. A mental health act is also expected to be approved in Turkey soon. Under the leadership of the Psychiatric Association of Turkey, non-governmental organizations operating in the field of mental health has contributed to the emergence of a comprehensive draft. The current draft, after extensive discussion and reiterations for almost a decade, was brought to a state close to its final form and accepted as a draft bill, ready to be legislated in the Turkish Grand National Assembly. This review will discuss the potential impact of the law in matters involving Forensic Psychiatry, and present our recommendations.

Method: Current draft, which has not yet been finalized, was compared to similar statutes in Massachusetts, USA, and potential benefits and pitfalls were discussed in light of experience with these laws in this jurisdiction.

Results: The draft introduces several new concepts and practices which have never existed in Turkey before. It also attempts to organize some of the existing de facto clinical practices in a uniform manner. As a whole, it appears to be in compliance with human rights and related international treaties. However, it is likely that some of the sections might have compliance issues in daily practice.

Conclusion: In this review, we aimed to draw attention to a number of issues, based on our experience in Massachusetts, USA, where similar laws have been in force for a very long time. Rather than literally comparing the statutes in both jurisdictions, we attempted to emphasize positive aspects as well as likely problems that we might encounter should Turkish draft be legislated in the present form.

Objective: In this study, the retinal nerve fiber layer (RNFL) thicknesses were compared between adult attention deficit hyperactivity disorder (ADHD) cases and healthy controls.

Method: The study included adults diagnosed with ADHD based on the DSM-5 criteria and age and gender matched healthy controls. Spectral area optical coherence tomography (OCT) was performed on the 52 eyes of 26 participants with ADHD and the 52 eyes of the 26 healthy control individuals.

Results: Comparing the data on the 52 eyes of 26 ADHD participants and the 52 eyes of 26 healthy control participants indicated that the central macular thickness (CMT) and the RNFL thicknesses, the ganglion cell complex (GCC), the mean inner macular ring (MIRAVG) and the mean outer macular ring (MOR-AVG) thicknesses were significantly lower in the ADHD group.

Conclusion: This is the first study in the literature on the RNFL thickness in adult ADHD patients. Our findings demonstrated that RNFL thickness is lower in ADHD cases as the unmyelinated axons are reduced in ADHD. Hence, the quantitative and reproducible nature of Spectral Domain-OCT thickness measurements can be used as biomarkers to monitor disease progression in ADHD cases.

Self-injurious behaviors (SIBs) in autism spectrum disorder (ASD) are destructive symptoms that can lead to dangerous injuries and life-threatening risks. Agitation and SIBs may not respond to psychopharmacological and behavioral interventions. There are reports in the literature on improvement after electroconvulsive therapy (ECT) in cases not responding pharmacotherapy. However, data on the efficacy of the therapy on the benefiting patients, the course of the treatment and on the use of maintenance ECT (m-ECT) are very limited. This report presents the clinical features and the course of m-ECT on two cases under follow up for pharmacotherapy resistant ASD with significant agitation, mood disorder and SIBs that could cause severe head traumas. The initial stage of therapy consisted of 7 sessions of ECT patients showed improvement after the 5th session. m-ECT were started since the agitation repeated one week after discharge despite ongoing pharmacotherapy. In the first case, m-ECT was continued once every two weeks for a total of 46 sessions; and in the second case a total of 18 weekly sessions were conducted. No significant side effects or complications were observed and the general state of well-being was preserved. Our paper is among the few that reported succesful treatment of agitation with m-ECT. m-ECT should be considered in treatment resistant cases.

Olfactory reference syndrome (ORS) is a rare psychiatric condition involving embarrassment and distress due to persistent mental preoccupation with the idea of emitting body odours foul and offensive enough to disturb others. This disorder is often accompanied by shame, embarrassment, significant distress, avoidance behavior, social phobia and social isolation. The patients may worry that they spread odours originating from their mouth, sweat, genital areas or the gut. This belief may lead the patients to misinterpret the behaviours of others, they may frequently smell themselves, shower and change clothing during the day. There are differences of opinion whether ORS should be considered as a delusional disorder or appear in under the rubric of obsessive-compulsive related disorders. One of the reasons that create this uncertainty is the variation in the response to different treatments. The treatment strategies generally include the use of antipsychotics, the antidepressants, they are preferentially used in combination. In this report we aimed to discuss the case of a 33-year old male patient whose first complaints had been diagnosed 14 years prior, with a diagnosis of OCD with low insight. Shortly after improvement of the OCD symptoms he developed ORS symptoms. We aimed here to discuss the place of ORS in the diagnostic systems with reference to this case.