Associated factors of legal child marriage in Turkey: pregnancy and below-average intelligence.

Turkish civil code permits child marriages at 16-17 years of age, but if a child is 16 years old judicial consent is needed. Before making a final decision on marriage consent, the judges refer these children to the doctor, and ask whether they are psychologically and physically ready for marriage. While the literature on child marriage in Turkey is rich, little is known about the underlying factors leading 16-year-old girls to request legal child marriage. This study examined the socio-demographic and clinical characteristics of girls applying to the courts for judicial marriage consent. Hospital records of girls admitted to a hospital in the Istanbul province of Turkey between January 2015 and December 2018 for the assessment of their physical and mental readiness for marriage were scanned. Of the 122 girls admitted to hospital for this purpose, eight were excluded as they had incomplete data, leaving 114 participating girls. All girls were Turkish citizens and had been referred from the law courts. Being pregnant/having a child (54.4%), having had a religious (non-legal) marriage (49.1%) and having an intelligence score of less than 90 (91.2%) were common among the participants. Among those who had a religious marriage, 78.6% were pregnant/had a child at the time of evaluation and 32.1% reported that they were pregnant before their religious marriage took place. None of the participants reported being forced to marry, but many had run away from home to marry (33.3%). Among those running away to marry, the major reason for deciding to do this was being pregnant (63.2%). Running away from home to marry was found to be related to lower parental educational levels (p<0.05). Contrary to the literature, the findings indicate that girls who request judicial consent for legal child marriage in Turkey are not being forced to marry. However, lower educational level seems to be an important factor. Below-average intelligence of the girl and her parents, running away from home to marry and early unsafe sexual intercourse, leading to child pregnancy, were found to be closely associated with legal child marriage in Turkey.

An Examination of the Relationships between Nurses' Team Work Attitudes, Conflicts with College and Job Satisfaction: An Example of a Public Hospital.

Nurses are one of the most important elements of the health system. In this study, it was aimed to determine the teamwork attitudes of nurses, their conflicts with their colleagues, their job satisfaction, to determine whether these variables differ according to the socio-demographic characteristics of the nurses, and to reveal the relationships between these variables. The data in the study were obtained from 253 nurses working in the Children's Hospital of Ankara City Hospital using a questionnaire method. A significant relationship was found between the teamwork attitudes of the nurses, their colleagues, and their level of conflict and job satisfaction.

Conversion Disorder Comorbidity and Childhood Trauma.

INTRODUCTION: The aim of this study is to examine the socio-demographic and clinical characteristics, the presence of comorbidity, and the link with childhood traumatic experiences in patients with conversion disorder (CD) in a psychiatric outpatient clinic. METHODS: A total of 60 literate, female patients between 18 and 65 years of age who were referred to the general psychiatry outpatient clinic and who were diagnosed with conversion disorder according to the DSM-IV diagnostic criteria were included in the study. A questionnaire on sociodemographic and clinical characteristics, the Brief Psychiatric Rating Scale (BPRS), the Hamilton Depression Rating Scale (HDRS), the Hamilton Anxiety Rating Scale (HARS), the Childhood Trauma Questionnaire (CTQ), and the Dissociative Events Scale (DES) were used to assess the cases. RESULTS: The mean age of the participants was 36.27±11.18 years. 72% of the patients were married and 63% were primary school graduates. The most common symptoms were asthenia (100%), aphasia (96.7%), and crying-convulsions (93%). The most common co-morbidities were depression (50%) and dissociative disorders (48.3%). Among the patients, 53.3% reported a history of exposure to physical violence and 25% reported a history of sexual assault in childhood. Assessment of the Childhood Traumatic Questionnaire revealed a significant positive relation between emotional, physical, and sexual abuse scores and DES score. CONCLUSION: CD has not yet been fully analyzed in detail in health institutions; co-existence of another mental disorder and the presence of traumatic experiences in the past further complicate the issue. Consideration of these factors during treatment will have a positive impact on the course and prognosis of the disorder.

Evaluation of effects of urinary incontinence subtypes on women's sexual function using the Golombok-Rust Inventory of Sexual Satisfaction.

AIM: The aim of this study was to compare the effects of urinary incontinence (UI) and subtypes, including urinary stress incontinence (USI), urinary urge incontinence (UUI), and urinary mixed incontinence (UMI), on sexual function and quality of life (QoL) of women. METHODS: Sexually active premenopausal consecutive women (n = 153) with UI were enrolled in this study. Sexual function was assessed with the Golombok-Rust Inventory of Sexual Satisfaction (GRISS), and QoL was assessed with the Urogenital Distress Inventory Short Form and the Incontinence Impact Questionnaire Short Form. RESULTS: The patient population (n = 153) was composed of women with USI (n = 20), UUI (n = 21), UMI (n = 40), and a control group (n = 72) assessed for only routine gynecological evaluation. Infrequency, dissatisfaction, avoidance, and anorgasmia were significantly higher in the UI group compared to the control group (P < 0.05). When we compared the USI, UUI, and UMI groups in terms of the subscales of the GRISS, dissatisfaction was significantly higher in the UMI group (P = 0.001). Scores for the Urogenital Distress Inventory Short Form and the Incontinence Impact Questionnaire Short Form were significantly higher in the UMI group compared with the UUI group (P < 0.05). CONCLUSION: UI has an adverse affect on sexual function and QoL of women. UMI has the greatest impact on sexual function in terms of dissatisfaction compared with USI and UUI. We suggest routine assessment of sexually active women with UI using specific questionnaires to diagnose and treat sexual dysfunction.

Illness perception of dropout patients followed up at bipolar outpatient clinic, Turkey.

Dropout is a common problem in the treatment of psychiatric illnesses including bipolar disorders (BD). The aim of the present study is to investigate illness perceptions of dropout patients with BD. A cross sectional study was done on the participants who attended the Mood Disorder Outpatient Clinic at least 3 times from January 2003 through June 2008, and then failed to attend clinic till to the last one year, 2009, determined as dropout. Thirty-nine dropout patients and 39 attendent patients with BD were recruited for this study. A sociodemographic form and brief illness perception questionnaire were used to capture data. The main reasons of patients with BD for dropout were difficulties of transport (31%), to visit another doctor (26%), giving up drugs (13%) and low education level (59%) is significant for dropout patients. The dropout patients reported that their illness did not critically influence their lives, their treatment had failed to control their illnesses, they had no symptoms, and that their illness did not emotionally affect them. In conclusion, the nonattendance of patients with serious mental illness can result in non-compliance of therapeutic drug regimens, and a recurrence of the appearance symptoms. The perception of illness in dropout patients with BD may be important for understanding and preventing nonattendance.

Working memory dysfunction in delusional disorders: an fMRI investigation.

BACKGROUND: Delusional disorder (DD) is a rare and understudied psychiatric disorder. There is limited number of studies concerning cognitive characteristics in DD. Using an established working memory paradigm with variable levels of memory load, we investigated alterations in functional magnetic resonance imaging (fMRI) of brain regions in patients with DD. METHODS: This case control study included 9 patients with DD and 9 healthy control subjects matched for age, sex, and education level. Diagnosis of DD was confirmed using the Structured Clinical Interview for DSM-IV Axis I. The severity of the symptoms was evaluated using the Positive and Negative Syndrome Scale. All patients were asked to perform 0-back and 2-back tasks during fMRI experiments. Functional imaging was performed using the 3.0 T Philips whole-body scanner using an 8-channel head coil. RESULTS: Participants with DD had less neural activation of the left dorsolateral prefrontal cortex in fMRI scans obtained during performance tasks. On the other hand, neural activation of the left and right superior temporal gyrus, left middle and inferior temporal gyrus, right and left posterior cingulate gyrus, right amygdala, left and right fusiform gyrus was more prominent in patients with DD in comparison with the control group. DISCUSSION: Patients with DD had dysfunction in the prefrontal, temporal and limbic regions of the brain in particular, during performance tasks of working memory. Our findings were in line with the findings of the early reports on deficient functioning in temporal or limbic regions of the brain. Further, patients with DD displayed prefrontal dysfunction as seen in patients with schizophrenia.