Risk factors for delaying treatment seeking in obsessive-compulsive disorder.

BACKGROUND: Despite the multiple alternatives of treatment, it is well known that patients with obsessive-compulsive disorder (OCD) delay seeking treatment. In this study, the aim was to determine the risk factors for delaying treatment seeking in OCD patients. METHODS: The sample consisted of 132 OCD who completed the Yale-Brown Obsessive-Compulsive Scale, Yale-Brown Obsessive-Compulsive Scale Symptom Checklist, and Beck Depression Inventory. RESULTS: In univariate analyses with risk evaluation, income level, being single or divorced, having a history of psychiatric treatment, poor insight for the symptoms, and obsessions of hoarding were the variables that were found to be significant. In the regression model, history of psychiatric treatment and duration of OCD were the 2 variables that remained statistically significant. CONCLUSION: This was the first study wherein the sample included patients who were recruited from a nonpsychiatric department: the dermatology clinic. Application to dermatology has not been determined as a risk factor for delaying treatment seeking in OCD patients.

[The symptomatology and prevalence of symptoms of premenstrual syndrome in Manisa, Turkey]. / Manisa ilinde premenstrüel sendrom belirti orüntüsü ve belirti yayginliginin arastirilmasi

OBJECTIVE: The aim of this study was to investigate the prevalence of premenstrual syndrome (PMS) symptoms, the frequency and severity of the symptoms, and their association with sociodemographic variables in fertile women between the ages of 15 and 49 years. METHOD: The study included 541 women living in the area of the 7th Primary Health Care Center of Manisa, Turkey. Face-to-face interviews were conducted and a sociodemographic data form, a DSM-IV diagnostic criteria form, and the premenstrual evaluation form (PEF) were administered. In the analysis of the data, K-means cluster analysis was performed and cluster analysis with 3 categories according to the severity was used. In the evaluation of the 18 subscales possible maximum variation quotient is obtained by dividing the maximum possible PEF score to the scores the subjects got. In the group comparison analyses, chi-square test for the categorical variables, and t-test for continuous variables were used. RESULTS: Among the study group, 6.1% had severe PMS symptoms and 72.2% of these women had some dysfunction as defined by DSM-IV. The most common symptoms were feeling irritable and restless (72%), anxiety (67.3%), feeling fullness, discomfort or pain in the abdomen (66.6%), lack of energy or easily fatigued (66.6%), and fatigue in the legs (65.5%). CONCLUSION: The prevalence of the risk of PMS was 6.1%. The most common and severe PMS symptoms were feeling irritable and restless.

The association of self-esteem, depression and body satisfaction with obesity among Turkish adolescents.

BACKGROUND: The purpose of this study was to determine the prevalence of overweight and obesity and to examine the effects of actual weight status, perceived weight status and body satisfaction on self-esteem and depression in a high school population in Turkey. METHODS: A cross-sectional survey of 2101 tenth-grade Turkish adolescents aged 15-18 was conducted. Body mass index (BMI) was calculated using weight and height measures. The overweight and obesity were based on the age- and gender-specific BMI cut-off points of the International Obesity Task Force values. Self-esteem was measured using the Rosenberg Self-Esteem Scale, and depression was measured using Children's Depression Inventory. Logistic regression analysis was used to examine relationships among the variables. RESULTS: Based on BMI cut-off points, 9.0% of the students were overweight and 1.1% were obese. Logistic regression analysis indicated that (1) being male and being from a higher socio-economical level were important in the prediction of overweight based on BMI; (2) being female and being from a higher socio-economical level were important in the prediction of perceived overweight; (3) being female was important in the prediction of body dissatisfaction; (4) body dissatisfaction was related to low self-esteem and depression, perceived overweight was related only to low self-esteem but actual overweight was not related to low self-esteem and depression in adolescents. CONCLUSION: The results of this study suggest that school-based adolescents in urban Turkey have a lower risk of overweight and obesity than adolescents in developed countries. The findings of this study suggest that psychological well-being of adolescents is more related to body satisfaction than actual and perceived weight status is.

[Case report: kleptomania and other psychiatric symptoms after carbon monoxide intoxication]. / Olgu Sunumu: Karbonmonoksit Zehirlenmesi Sonrasinda Ortaya Cikan Kleptomani ve Diger Psikiyatrik Belirtiler.

Carbon monoxide (CO) intoxication is usually a serious condition, which can result in neurological disturbances or death. In some patients with CO intoxication, but not usually, a biphasic pattern can be seen. In this condition, after antitoxic treatment, patients may completely recover and after a short recovery period, neurological and/or psychiatric symptoms appear again. This condition is known as delayed encephalopathy and its occurrence rate is between 0.06% and 11.8%. Herein, we report a case with delayed encephalopathy after CO intoxication, which began with neurological symptoms and continued with obsessive-compulsive disorder, depression, kleptomania, and psychotic disorder. The 41-year-old female patient had no psychiatric or neurological symptoms or disorders prior to CO intoxication. Increased signal intensity changes in the basal region of the left temporal lobe (including the cortex and subcortical white matter), globus pallidus (bilateral), and cerebellar cortical and subcortical white matter (bilaterally symmetrical) was detected on axial T2-weighted magnetic resonance imaging (MRI). In addition, there were atrophic changes in both cerebellar hemispheres. To the best of our knowledge, this is the first case of kleptomania described after CO intoxication in the literature. We discuss the organic etiology of kleptomania and the other psychiatric symptoms of this patient in the light of recent research. We concluded that the kleptomania seen in this patient was related to concurrent lesions in the temporal lobe and globus pallidus; in other words, her kleptomania may have been related to dysfunction simultaneously seen in both the temporolimbic and frontal-subcortical circuits.

Obsessive-compulsive disorder in a dermatology outpatient clinic.

OBJECTIVE: The aims of present study were to (a) to determine the prevalence of obsessive-compulsive disorder (OCD) in dermatological patients, (b) to determine the possible relationship between dermatological lesions and OCD and (c) to determine the clinical and phenomenological features of the OCD subgroup. METHOD: The sample consisted of 166 out of 250 consecutively presenting dermatological patients who agreed to participate in the study. The subjects were assessed with the Structured Clinical Interview for DSM-IV Turkish Version (SCID-I) and also completed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). RESULTS: Of the whole sample, 41 (24.7%) met DSM-IV criteria for OCD. Only 14.6% of them had previously been diagnosed as OCD. The mean score of Y-BOCS in the OCD group was 17.05 +/- 9.75. The most common obsessions were contamination (61%) and pathologic doubt (53.7%), while washing (61%) and checking (51.2%) were the most frequent compulsions. Those suffering from diseases of sebaceous glands were the only group that showed a significant difference between the OCD and non-OCD group. CONCLUSION: There is a high prevalence of OCD in dermatological patients, although the nature of the relationship between OCD and dermatology has not previously been ascertained. Genetic-based studies and future researches focused on individual anxiety, and sensitivity may provide information that better explains this relationship.

[The prevalence of suicide ideation and suicide attempts in Manisa City Centre]. / Manisa Ili Kent Merkezinde Intihar Düsüncesi ve Girisimi Yayginligi.

OBJECTIVE: Suicide attempts are a major public health problem. This study aimed to investigate the lifetime prevalence of suicide ideation and suicide attempts in Manisa city centre. Risk factors related to suicide ideations and attempts were also studied. METHOD: This study was carried out in Manisa city centre. Using cluster and systematic samples, data were collected from 1086 persons 15-65 years old. Separate questions were asked about the lifetime occurrence of suicide ideation (''Have you ever seriously thought about committing suicide?''), and suicide attempts (''Have you ever attempted suicide?''). A form for suicide attempters was used to determine the characteristics of the attempts. RESULTS: The lifetime prevalences of suicide ideation and suicide attempts were 6.6% (n=72) and 2.3% (n=25), respectively. Marital problems were the most common stressor in suicide attempts (44%, n=11). Approximately two thirds of the suicide attempters used a drug overdose for suicide. Of all the suicide attempters, 24% (n=6) had made previous attempts. The essential risk factors for suicide ideation were being female (p=0.012), smoking (p=0.001), consuming alcohol (p=0.028), having a previous psychiatric disorder (p<0.0001), and a family history of psychiatric disorders (p=0.021). The essential risk factors for suicide attempts were smoking (p=0.005), having a previous psychiatric disorder (p<0.0001), and a family history of psychiatric disorders (p=0.029). CONCLUSION: The results of the present study suggest that suicide attempts must be carefully evaluated in subjects with previous psychiatric disorders, previous suicide attempts and a family history of psychiatric disorders. It is necessary to know the clinical and demographic features related to suicide attempts.

[Which psychiatric label is more stigmatizating? "ruhsal hastalik" or "akil hastaligi"]. / Hangi etiket daha damgalayici: ruhsal hastalik mi? Akil hastaligi mi?

OBJECTIVE: To determine which of the two different labels, "ruhsal hastalik" or "akil hastaligi", used for psychiatric disorders by the public in Turkey is more stigmatizing. METHOD: This study was carried out at Celal Bayar University School of Health in Turkey. The questionnaire was designed by the researchers and applied to all students (n=272) present at the school on the day of application. The attitudes and opinions of students were investigated using case vignettes describing sczhizophrenia and major depression. RESULTS: It was seen that 0.8% of the students described the depression vignette as "akil hastaligi" while 78% described it as "ruhsal hastalik" with the schizophrenia vignette, 26% of students described it as "akil hastaligi" while 65% described it as "ruhsal hastalik". The participants who described the schizophrenia vignette as "akil hastaligi" stated that persons with symptoms like those of the schizophrenia vignette should not be free in the community (p<0.0001), they would not rent their house to a person with schizophrenia (p=0.013) and persons with schizophrenia are aggressive (p<0.0001); they had more negative attitudes than the participants who described it as "ruhsal hastalik" CONCLUSION: The results of this study suggest that the concepts "akil hastaligi" and "ruhsal hastalik" are used in different ways and the concept "akil hastaligi" has a more stigmatizing meaning. Therefore "akil hastaligi" should be avoided by health professionals when dealing with patients.

Public attitudes to schizophrenia in rural Turkey.

BACKGROUND: The aim of this study was to determine the public's attitudes and their correlates towards patients with schizophrenia in rural areas. METHODS: The study was carried out in a village near Manisa City, Turkey. Two hundred and eight subjects completed the public survey form which consists of ten items screening demographic and health status and 32 items rating attitudes towards schizophrenia. RESULTS: Half of the subjects stated that persons with schizophrenia are aggressive and that they should not be free in the community. More than half of the subjects stated that they would be irritated about having a neighbour with schizophrenia (61.5%), that they would not rent their home to a person with schizophrenia (58.2%), that they do not want to work with a person with schizophrenia (61.1%), and that they would not get married to a person with schizophrenia (85.6%). CONCLUSIONS: The public in rural areas sufficiently recognises schizophrenia but has a tendency to stigmatise schizophrenic patients. Their attitudes are generally negative and rejective. They do not want close contact with schizophrenic patients. Interpretation of schizophrenia as a mental illness leads to more negative attitudes and increases the social distance.

[Depressive symptomatology among elderly residential home residents in Manisa: prevalence and related risk factors]. / Manisa huzurevlerinde kalan yaslilarda depresyon belirtilerinin yayginligi ve iliskili risk etkenleri.

OBJECTIVE: To determine the prevalence of depression and related factors among elderly residential home residents in Manisa. METHODS: The study was carried out in all residential homes in Manisa and the surrounding towns. One hundred and forty-five residents completed a form asking questions about demographic features, health conditions and the pattern of relationships with their relatives, the employees of the home, and the other residents. The Geriatric Depression Scale Turkish Form (GDS-TF) was used. The data was analysed by logistic regression to determine the factors which had an effect on the presence of depression. RESULTS: The mean age of the sample was 73.9 +/- 9.2 and the mean score of GDS-TF was 11.9 +/- 6.52. Some 35.9% of subjects were depressed according to the cutoff point of 13/14 for the GDS-Turkish Form. Associations between dissatisfaction with the perceived social level (p=0.004), decline in the ability to perform personal care (p=0.045), having worries about leaving the home (p<0.001), the lack of enthusiasm for participating in social activities (p=0.007), not being pleased with the physical conditions of the home (p=0.032) and the presence of depression were determined. CONCLUSION: The prevalence of depression, which is common in residential homes is not associated with the social support from outside the home, and the feelings of belonging towards the institution and other residents are more important than non-institutional social support.

[The public attitudes towards schizophrenia in a rural area in Turkey]. / Türkiye'de kirsal bir bölgede yasayan halkin sizofreniye iliskin tutumlari.

OBJECTIVE: To determine the public's attitude about schizophrenia and its related factors in a rural population. METHODS: This study was carried out in a village of Manisa. Of the 245 subjects which met the inclusion criteria, 230 subjects were reached and 208 of them constituted the sample of this study. The subjects filled out the sociodemographic information form and the 32-item subscale for schizophrenia of a public survey form which was developed by Psychiatric Research and Education Center. RESULTS: Of the 208 subjects, 76.3% appraised the schizophrenia as an illness, 62.0% considered it as a mental disease, 76.9% noted that social problems were the most frequent etiological factor, 66.8% denoted that the patient should consult with a psychiatrist for the treatment, 61.5% indicated that they would feel uncomfortable with a neighbor with schizophrenia, 61.1% declared that they didn't want to work with anyone with schizophrenia. CONCLUSION: The majority of subjects in rural population recognize the schizophrenia as a mental disease. Social problems are determined as the first-rank etiological factor by the subjects. The public has an adequate knowledge about the treatment of schizophrenia. However they hesitate to apply to psychiatric treatment because of the fear of stigmatisation. The public has a reluctant attitude in becoming close to the patients and has a rejective attitude in keeping a certain distance with the patients. The sociodemographic factors do not seem to have any influence on the attitudes towards the schizophrenia.