An Evaluation of Psychogenic Predictors of Non-Organic Erectile Dysfunction.

Background and Objectives: Erectile dysfunction is a significant problem, which diminishes the quality of life. The aim of this study was to investigate the relationship of childhood trauma and attachment styles in the aetiology of psychogenic erectile dysfunction. Materials and Methods: The study included 80 participants (40 patients who presented with the complaint of erectile dysfunction, were not determined with an organic pathology, and were diagnosed with erectile dysfunction according to the DSM-5 criteria; and a control group of 40 healthy subjects.) The structured clinical interview form for DSM-5 (SCID-5) was applied to all the participants, together with the International Erectile Function Index (IIEF), the Childhood Trauma Questionnaire (CTQ), the Relationship Scale Questionnaire (RSQ), and the Beck Depression Inventory (BDI). Results: The emotional abuse (p = 0.002), physical abuse (p = 0.049), emotional neglect (p = 0.004), physical neglect (p = 0.002), and total scale points of the CTQ were determined to be significantly higher in the patient group than in the control group. Secure (p = 0.022) and dismissive (p = 0.009) attachment styles were found to be higher in the control group. As the time together with the current sexual partner increased, so the severity of erectile dysfunction increased, and sexual function, orgasmic function, sexual satisfaction, and general satisfaction decreased. As emotional abuse, sexual abuse, and physical neglect increased, the severity of erectile dysfunction increased. Childhood trauma (ß = -0.275, t (73) = -2.704, p = 0.009) and the duration together with the partner (ß = -0.249, t (73) = -2.512, p = 0.014) were found to be predictive of erectile dysfunction. Conclusions: The results of this study demonstrated that childhood trauma and the time elapsed without treatment are predictors of psychogenic erectile dysfunction severity, and secure attachment style and self-esteem play an important role in the aetiology of psychogenic erectile dysfunction.

Cognitive outcomes of transcranial magnetic stimulation in treatment-resistant depression: a randomized controlled study.

BACKGROUND: Major depressive disorder (MDD) is a significant cause of workforce loss, and is associated with cognitive impairments which can continue even after the elimination of mood and behavioural symptoms. The aim of this study was to investigate the benefit of transcranial magnetic stimulation (TMS) on cognitive functions in treatment resistant depression. METHODS: This randomised controlled clinical trial was conducted at a university hospital, department of psychiatry (tertiary centre) between October 2019 and July 2020. The study included 30 patients with depressive disorder, aged 18-50 years, who did not respond to at least two antidepressant medications for at least 8 weeks (one drug used was serotonin norepinephrine reuptake inhibitor [SNRI]; and 15 healthy control subjects. The patients were separated into two equal groups in a double-blind, random manner, and 20 sessions of repeated TMS was applied to one group, and 20 sessions of sham TMS to the other. The Montgomery Asberg Depression Scale (MADRS), Hamilton Depression Rating Scale (HAM-D), Stroop test, Wisconsin Card Sorting Test (WCST), Digit Span Test (DST), Trail Making Test A-B, and Verbal Memory Processes Test (VMPT) were applied to the patients before and after the TMS procedure. RESULTS: The decrease in the HAM-D score was greater in the active magnetic stimulation (25 trains, 10 Hz, 110% motor threshold intensity) group, and with the exception of verbal memory processes, better performance was obtained by the active magnetic stimulation group than the sham group in the cognitive function tests. DISCUSSION: TMS was seen toimprove the cognitive defects present in the active phase of treatment-resistant depression, and therefore TMS could provide early improvement in cognitive functions in clinical use. Key words: Depression, transcranial magnetic stimulation, neurocognitive functi.

Efficacy of transcranial magnetic stimulation in treatment-resistant depression.

BACKGROUND: The use of Transcranial Magnetic Stimulation (TMS) in the add-on treatment of patients with treatment-resistant depression (TRD) is becoming more common. This study aims to investigate the efficacy of TMS on depression and accompanying anxiety symptoms among patients with TRD. METHODS: The current study was conducted with 38 patients diagnosed with TRD. The patients were randomly divided into two groups and received 20 sessions of high-frequency (10Hz) TMS and 20 sessions of sham TMS to the left dorsolateral prefrontal cortex in a double-blind and cross-over fashion without a change in their pharmacotherapy. In the clinical evaluation, Hamilton Depression Rating Scale (HAM-D) and Hamilton Anxiety Rating Scale (HAM-A) were carried out three times in total: before, crossover phase, and at the end of the treatment. RESULTS: A statistically significant decrease was found in the HAM-D and HAM-A in the group who were actively stimulated in the cross-over phase of the study. While there was a significant decrease in the HAM-A in the group who received sham stimulation, the decrease in the HAM-D was not statistically significant. Group comparisons revealed a statistically significant decrease in HAM-D in the group who were actively stimulated compared to the group receiving sham stimulation. At the end of the study, 63% of 38 patients responded to treatment, 15% partially responded, and 42% reached remission. DISCUSSION: This randomized, double-blind, sham-controlled, cross-over study revealed that TMS is superior to sham-TMS, provides clinically significant improvement when implemented besides pharmacotherapy among patients with treatment-resistant depression, and is beneficial for accompanying anxiety symptoms.

Involuntary social cue integration in patients with obsessive compulsive disorder.

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.

Effect of Psychodrama Group Therapy on Remission and Relapse in Opioid Dependence.

INTRODUCTION: Relapse is one of the most common problems in the addiction treatment. The aim of this study was to increase the remission rates, reduce relapse rates and investigate the effect of psychodrama on depression, anxiety and locus of control after treatment in a group of inpatients diagnosed with opioid use disorder (OUD). METHOD: The study was started with 13 inpatients diagnosed with OUD and completed with six members. In addition to psychoeducation, the psychodrama study of 13 sessions lasted. The control group consisted of six individuals with the same diagnosis and characteristics, who had only undergone psychoeducation. Hamilton Depression-Anxiety and Rotter Locus of Control Scales were applied to the participants before and after the group. RESULTS: Anxiety rates decreased in both groups according to pre-test and post-test results. In the outpatient part of the study, five patients in the patient group remained in treatment and clean at the end of the fifth month and four at the end of the sixth month. In the control group only two people could remain in treatment and clean at the end of the sixth month. The most effective psychodrama techniques were empty chair, doubling and mirroring. DISCUSSION: Both psychodrama techniques and SAMBA program are applications that reduce anxiety levels of patients. It was concluded that psychodrama applications aimed at increasing the internal control belief may be beneficial in terms of increasing the motivation of the patients and coping with relapse.

Study on Dorsolateral Prefrontal Cortex Neurochemical Metabolite Levels of Patients with Major Depression Using H-MRS Technique. / Major Depresyon Bozuklugu Olan Hastalarda H-MRS Yöntemi ile Dorsolateral Prefrontal Korteks Nörokimyasal Metabolit Düzeyleri.

OBJECTIVE: . The aim of the study is to investigate, by using proton magnetic resonance spectroscopy (1H-MRS), the effects of major depression on the biochemistry of the brain, the relationship between the parametric changes demonstrated and cognitive functions, and the effects of antidepressant treatment. METHOD: The study included 30 patients, diagnosed with moderate/ severe non-chronic major depression disorder (NC-MDD) according to the DSM-5 diagnostic criteria, and 30 healthy individuals as the control group. The dorsolateral prefrontal cortex (DLPFC) areas of the patients and the control individuals were scanned bilaterally by 1H-MRS. The participants were also tested on the brief computerized version of the Wisconsin Card Sorting Test (or, Berg's "Wisconsin" Card Sorting TestWCST). After antidepressant treatment for a minimum of 8 weeks, the patients who scored below 7 on the Hamilton Depression Rating Scale (HAM-D), were assessed with the 1H-MRS scan and the WCST. RESULTS: The Glx level in the left DLPFC was significantly lower in the patient group. Differences were not determined between the NAA, Cr, Cho levels in the right and the left DLPFC of the patient and the control groups. After the treatment, Glx level in the left DLPFC increased; but the levels of the other metabolites did not change. Before the treatment, the abilities of the patient group in changing strategy and problem solving, as assessed by the WCST, were lower in comparison to the control group. After the treatment the patient group improved clinically and performed significantly better on the WCST. CONCLUSION: In the present neuroimaging (NI) study, it was determined that the Glx level in the left DLPFC of patients with moderate/severe NC-MDD improved together with the clinical features after treatment. Neurocognitive functions also improved after treatment. However, a correlation between the change in the metabolite levels and the performance on the WCST could not be demonstrated.

Sympathetic Skin Response in Social Anxiety Disorder and Its Relationship with Empathy Skills, Alexithymia.

INTRODUCTION: Psycho-behavioral studies have shown that sympathetic skin response (SSR), which is an indicator of sympathetic function, is associated with emotional responses. It has been reported that SSR, which is claimed to be a biological indicator of empathy, has increased in Social Anxiety Disorder (SAD) patients. The aim of this study was to evaluate the relationship between SSR and alexithymia, empathy in patients with SAD. METHOD: SAD patients and control group were applied Liebowitz Social Anxiety Scale, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Toronto Alexithymia Scale, Empathy Quotient, Facial Emotion Identification and Discrimination tests (FID, FDSC); during the application FID, SSR were measured. The relationship between alexithymia and empathy levels were investigated. RESULTS: The number of SSR was higher in all visual stimuli of SAD patients (11.13±3.01) compared to the control group (7.4±3.57). More autonomous activity to negative stimuli (SAD: 10.55±2.82, control: 6.36±3.64), sensitivity to positive stimuli (SAD: 0.58±0.69, control: 1.03±0.8) was less than control group. While 41.7% of SAD patients had alexithymic features, 36.1% were diagnosed with depressive disorder. CONCLUSION: It was thought that depressive and alexithymic features may have contributed to increased sympathetic sensitivity to negative stimuli in SAD patients. Further studies are needed to examine the effects of this situation on the selection and creation of the treatment modalities.

Schizophrenia with obsessive-compulsive disorder and obsessive-compulsive disorder with poor insight: a neuropsychological comparison.

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.

Psychopathology in thalassemia major.

BACKGROUND: Thalassemia major (TM) is a chronic disease with adverse emotional effects on both the child and the family. The aim of this study was to investigate the psychiatric state and behavioral problems of children with TM. METHODS: Twenty children diagnosed with TM and 34 healthy children were enrolled in this study carried out by the Pamukkale University Faculty of Medicine, Department of Pediatrics. Mothers of the children of both the groups were handed a child behavior check-list for 4-18-year-old children and adolescents as well as a short questionnaire requesting demographic information. RESULTS: The psychiatric diagnosis was significantly higher in the children with TM (55.0%) as compared to the control group (14.7%). The thalassemic children showed an anxiety disorder frequency of 30.0% and a depressive disorder frequency of 15.0%. T scores of the indicators of internalizing problems, externalizing problems, attention problems and social problems contained in the child behavior check-list were shown to be higher in children with TM than in the control group. The TM group demonstrated significantly higher problems in peer relationships and educational success in comparison with the controls. CONCLUSION: Children with TM are posed with an increased risk of psychopathology.

Characteristics of suicidal behavior in a Turkish sample.

BACKGROUND: Suicidal behavior is one of the most important problems in psychiatric clinics. Several sociodemographic and clinical characteristics may have different effects on suicidal behavior. AIMS: To examine the sociodemographic and clinical characteristics of a sample of 144 suicide attempters admitted to a Turkish emergency clinic for a suicide attempt. METHODS: All subjects were interviewed by a consultant psychiatrist. For all individuals, data on DSM-IV psychiatric diagnoses, sociodemographic data, Beck's Hopelessness Scale (BHS), Becks's Suicidal Ideation Scale (SIS), and Beck's Suicidal Intention Scale (BSIS) were collected. RESULTS: The majority of suicide attempters were females characterized by low educational status and low religious orientation. Drug overdose was the most common method of suicide attempt and conflict within the family was the most frequent psychological stress factor. Three-quarters of 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.

Cognitive functions in euthymic patients with bipolar disorder.

BACKGROUND: Recent studies have focused on the nature of cognitive dysfunction in bipolar patients. The purpose of the current study was to investigate cognitive performance of individuals with bipolar disorder compared to healthy control subjects during a well-established euthymic period. METHODS: The sample consisted of 27 bipolar euthymic patients and 21 control subjects. Verbal and visual memory performance, attention, executive functions and psychosocial functions were evaluated for each participant. RESULTS: Bipolar patients showed significant attentional deficit and executive dysfunction and also poor performance on verbal and visual memory tasks compared to the controls. Illness duration and lifetime total episode number and previous episode with psychotic features was associated with worsened performance on attention, executive and memory tasks. Psychosocial functioning was not associated with cognitive deficit. CONCLUSIONS: The present study showed persistent cognitive impairment on inhibitory control and selective attention as well as poor performance on verbal and visual memory tests in a group of bipolar euthymic patients. The impaired neuropsychological performance was associated with duration of illness, total number of episodes per lifetime, and previous episodes with psychotic features. Attentional dysfunction seemed to be a trait abnormality for the sample studied.

[Development of a questionnaire to assess inter-episode functioning in bipolar disorder: Bipolar Disorder Functioning Questionnaire]. / Bipolar Bozuklukta Islevsellik Olçeginin Gelistirilmesi, Güvenilirlik ve Geçerliligi.

OBJECTIVE: Even though quality of life and functioning are topics that are point of interest, they are not assessed adequately in mood disorders. In this study, it is aimed to develop a functioning assessment scale in bipolar disorder. METHOD: Bipolar Disorder Functioning Questionnaire (BDFQ) is developed by the Scientific Section for Mood Disorders of the Psychiatric Association of Turkey. The questionnaire contains 58 items, and consists of eleven subscales: emotional functioning, intellectual functioning, sexual functioning, feelings of stigmatization, social withdrawal, household relations, relations with friends, participation to social activities, daily activities and hobbies, taking initiative and self sufficiency, and occupation. RESULTS: In this study, 252 remitted bipolar patients from 15 centers were included. In addition, thirty subjects without any lifetime psychiatric, neurological or physical disease were recruited. The mean age of the patients was 38.6+/-12.1 and 56% (n=141) were female. The mean duration of the bipolar disorder was 11.9+/-9.2 years, and 91.3% of the patients were diagnosed to have bipolar I disorder. In the reliability analyses, after the exclusion of six items with low reliability coefficients, The Cronbach alpha coefficient was calculated to be 0.91. The item-total scale correlations were between 0.22-0.86. In test-retest reliability, the correlation between the two ratings was high (r=0.82, p<0.0001). In validity analyses, 13 factors were obtained representing 65.1% of the total variance in exploratory factor analysis. In confirmatory factor analysis, 11 domains fit the model with a RMSEA of 0.061. BDFQ significantly correlated with GAF (r=0.428, p<.0001). BDFQ also showed significantly negative correlation with HAM-D (r=-0.541, p<0.0001) and YMRS (r=-0.365, p<0.0001). It discriminated the patients (mean score=111.8+/-15.2) from the healthy subjects (mean score=121.4+/-10.4) well (t=-2.300, p=0.038). CONCLUSION: With the six items excluded, it is suggested that the 52-item BDFQ is a reliable and valid instrument in the assessment of functioning in bipolar disorder.

Does corticosteroid usage in rhinoplasty cause mood changes?

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, reoperative 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.

[The elderly, nursing homes and life voyages: a psychodrama group study]. / Yaslilik, Huzurevi ve Yasam Yolculuklari Bir Psikodrama Grup Calismasi.

OBJECTIVE: To investigate the applicability of psychodrama orientated group work among the elderly living in nursing homes, and effect of this group work on coping with psychological and behavioral problems. METHOD: Eleven male volunteers were chosen for the group. None of them had any negative features on communicating with others or had somatic or serious psychological problems. Eighteen psychodrama orientated group work sessions were held. Each was 2.5 to 3 hours long and took place only once a week. The staff of the nursing home became involved in the process after the twelfth session. Therapists registered their observations at every meeting. To evaluate the anxiety-depression levels the Geriatric Depression Scale and Hamilton Anxiety Rating Scale were used. RESULTS: Due to a late warm up among the members in this group, dramatization took place in later sessions. During the study, an increase in the members' spontaneity, creativity and empathy and consequently an improvement in communicating with and helping others, and coping with problems were observed. Articulation of emotions and thoughts improved gradually during the study. Somatic and total anxiety scores decreased significantly. CONCLUSION: This study shows that psychodrama group work can be used with the elderly and it may be helpful for improving psychological and behavioral areas, and for discovering the meaning of life.

Relationship between Obsessive Beliefs and Symptoms in Patients with Obsessive Compulsive Disorder.

INTRODUCTION: Misinterpretation of intrusive thoughts because of obsessive beliefs has been thought to be important in the development of obsessive compulsive symptoms. In current study, (I) the difference between OCD patients and healthy controls in regard of obsessive beliefs and (II) the relation of obsesive beliefs with the prevelance and severity of obsessive compulsive symptoms was investigated. METHODS: The current study included 47 OCD patients and 44 healthy controls who have same properties with regard to age, sex and duration of education. All subjects were applied to Obsessive Beliefs Scale, Maudsley Obsessive Compulsive Scale, Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale. OCD patients were applied to Yale Brown Obsessive Compulsive Scale as well as the other scales. RESULTS: In analyses by controlling depression and anxiety scores, OCD patients had significantly higher scores than controls, with regard to all subscales of Obsessive Beliefs Scale. Also, prevalence of obsessive compulsive symptoms other than cleaning were correlated with obsessive beliefs about "responsibility and threat estimation" and "perfectionism and need for certainty". Hovewer, there was no correlation in between severity of obsessive compulsive symptoms and subscale scores of Obsessive Beliefs Scale. CONCLUSION: Excluding the effects of depression and anxiety, generally the results suggests that obsessive beliefs have an important role for development of obsessive compulsive symptoms. Future studies of seperated OCD subgroup with regard to obsessive compulsive symptoms will be helpful in determinig the difference among these subgroups in regard of obsessive beliefs.

Demographical, clinical, and psychological differences of patients who suffered hand injury accidentally and by punching glass.

OBJECTIVE: The aim of this study was to compare patients who were injured by punching glass with patients who were injured accidentally, according to demographical, clinical, and psychological parameters. METHODS: The Hand Injury Severity Score (HISS), the Duruöz Hand Index, the Quick Disabilities of the Arm, Shoulder and Hand scale (Q-DASH), the Impact of Event Scale-Revised (IES-R), the Adult Attention-Deficiency/Hyperactivity Scale (A-ADHS), the Borderline Personality Inventory (BPI), and the Beck Depression Inventory (BDI) were used for evaluating severity of the injury, functionality, impact of the injury on the patient, attention deficiency, patterns of borderline personality symptoms, and level of depression, respectively. RESULTS: Patients who were injured by punching glass were significantly younger and more likely to injure their dominant hand. The severity of injury and all psychological scales were significantly higher in patients who were injured by punching glass. CONCLUSION: Hand therapy specialists should be aware of potential problems in patients who were injured by punching glass.

Psychological Symptoms in Obesity and Related Factors.

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.

Seasonal affective disorder in eight groups in Turkey: a cross-national perspective.

OBJECTIVE: Previous estimates of the prevalence of seasonal affective disorder (SAD) in community-based samples generally originated from western countries. We report prevalence rates in eight groups from four latitudes in Turkey. METHOD: Seasonal Pattern Assessment Questionnaire (SPAQ) was distributed to the community-based samples from eight different locations at four latitudes in Turkey. The prevalence rates of winter SAD and subsyndromal SAD (S-SAD) were estimated for the four groups at the same latitudes by using SPAQ responses. RESULTS: We distributed 3229 SPAQs, had an overall response rate of 54.16% and 1749 SPAQs were included in the analyses. Seasonality was reported as a problem by 549 subjects (31.57%) of our 1749 respondents. Prevalence of winter SAD and S-SAD are estimated as 4.86 and 8.35%, respectively, for the whole group. Prevalence rates were determined for each center and for four latitudes (two centers at the same latitude were grouped as one). In Adana-Gaziantep (lt. 37), Izmir-Elazig (lt. 38), Eskisehir-Ankara (lt. 39) and Trabzon-Edirne (lt. 41), the prevalence rates for winter SAD were 6.66, 2.25, 8.00 and 3.76%, respectively. CONCLUSIONS: Our prevalence estimates of winter SAD are similar to those found in previous community-based studies at the same latitudes; no correlation was found between latitude and prevalence of winter SAD, which could be related to the sampling methodology or to the fact that there were only 5 degrees of difference between the latitudes.

[Reliability and validity of the Cornell Scale for Depression in Dementia in an elderly Turkish population]. / Cornell Demansta Depresyon Olçegi'nin Türk yasli toplumunda geçerlik ve güvenilirligi.

OBJECTIVE: The reliability and validity of the Cornell Scale for Depression in Dementia were investigated in a Turkish population over 60 years of age. METHOD: Forty-six male and 34 female demented elderly people classified as demented according to DSM-IV criteria were included in the study. The Structured Clinical Interview for DSM-IV Clinical Version (SCID-I) was completed for all subjects to establish the diagnosis of major depression. The Cornell Scale for Depression in Dementia (CSDD), Geriatric Depression Scale (GDS), Mini Mental State Examination (MMSE) and Global Deterioration Scale (GDS) were used. RESULTS: A high test-retest correlation level (r: 0.93) was obtained for the total scores of the scale. The scale also showed high internal consistency (a: 0.86). The validity analysis of the scale resulted in a significant difference (p<0.001) between the total scores of the group with dementia and depression and the group with dementia but without depression. Two items (9-19) showed a low correlation (r<.30) in the test-retest analysis. On the other hand, two items (6-19) had a low item-total score correlation (r<.30). CONCLUSIONS: The results indicated that the scale is reliable and valid for diagnosing depression in dementia in an elderly Turkish population. We expect that the Cornell Scale for Depression in Dementia will be a useful instrument in pharmacological investigations and in studies of the phenomenology and course of depressive symptoms in demented patients.

[An anorexia nervosa case and an approach to this case with pharmacotherapy and psychodrama techniques]. / Bir anoreksiya nervosa olgusu ve bu olguya farmakoterapi ile birlikte psikodrama teknikleri ile yaklasim.

Anorexia nervosa in an eating disorder that primarily affects female adolescents and is more commonly seen in westernized countries. Although it is a sociocultural problem of developed societies, nowadays it is also increasing rapidly in developing cultures such as Turkey. Difficulties in the treatment of anorexia nervosa have directed clinicians to understand the disorder better. Although it is well known that various factors play a role in the etiology of anorexia nervosa, psychodynamic factors also have considerable importance. In addition, social and familial interactions contribute to the development of anorexia nervosa. In the light of these facts, treatment with psychotherapy and pharmacotherapy might be used to cure this disorder. In this article, the definitive features and process of anorexia nervosa along with its psychodynamics were discussed on the basis of a case. In the treatment of the patient, psychodrama techniques with drugs were thought to be useful. The patient became aware of the unfavourable relationship and improved by the use of this method. Thus she gained emotional-cognitive insight.