The relationship between psychopathology, occupational balance, and quality of life among people with schizophrenia.

OBJECTIVE: There is an increased risk of occupational imbalance and poor quality of life (QoL) if one has schizophrenia. Although evidence suggests a relationship between psychopathology and QoL, the association of occupational balance (OB) with QoL in schizophrenia is unclear. This study aimed to investigate the associations among psychopathology, occupational balance, and QoL in schizophrenia. METHODS: This was a cross-sectional study carried out in a Community Mental Health Center (CMHC). Ninety-five individuals aged 18 years or older with the diagnosis of schizophrenia participated in the study. All participants completed a sociodemographic form, Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale in Schizophrenia (CDSS), Occupational Balance Questionnaire-11 Turkish Version (OBQ11-T), and the World Health Organisation Quality of Life Assessment Instrument (WHOQOL-100-TR). Relationships among clinical and depressive symptoms, OB, and QoL variables were examined through correlation analysis, and then multiple linear regression analysis was performed to determine the variables that have influences on QOL. RESULTS: The study participants had low OB scores and the lowest mean in the WHOQOL-social relationships subscale. WHOQOL-overall QoL score demonstrated a moderate negative correlation with the PANSS-total score and PANSS-general psychopathology subscale score (r = -0.422, r = -0.463, P < 0.001) and a mild negative correlation with the CDSS-total score (r = -0.390, P < 0.001). OBQ11-T total score showed a moderate positive correlation with the WHOQOL-overall score (r = 0.549; P < 0.001). Findings from the multiple linear regression analysis revealed that OBQ11-T (ß = -0.467, P = 0.000) and PANSS-general psychopathology (ß = -0.221, P = 0.045) were significant predictors of the overall QoL, explaining 48% of the variance in the overall QoL (adjusted R2 = .43, P < 0.001). CONCLUSION: Our study findings showed that OB and general psychopathology are determinants that should be considered in improving the QoL in individuals with schizophrenia. Thereby, addressing the symptoms of general psychopathology and occupational factors to improve the QoL may be achieved with the incorporation of occupation-based programmes to routine treatment. However, further research is required.

Treatment strategies in management of schizophrenia patients with persistent symptoms in daily practice: a retrospective study.

OBJECTIVES: One-third of the patients with schizophrenia show treatment resistance and literature on the effectiveness of interventions in patients with persistent symptoms is conflicting. This study aimed to assess clinical preferences of clinicians in those showing treatment resistance to antipsychotics and to determine correlates of interventions. METHODS: Treatment strategies applied in the patients with schizophrenia in daily practice were inquired retrospectively. Those showing poor response to at least two antipsychotics and were administered a clinical intervention in a University Hospital between January and September 2018 were included. Clinical correlates of distinct interventions were evaluated. RESULTS: The most common intervention (47%) was transition to a long-acting injectable antipsychotic (LAIA) and the second most common (22%) was addition of a second/third oral drug to on-going oral therapy. Switching to clozapine was more effective on positive symptoms comparing with the other interventions (p < 0.01). LAIA therapy showed a superiority over oral antipsychotic interventions at improving positive symptoms, except clozapine (p < 0.01). CONCLUSIONS: LAIA administration and oral antipsychotic augmentation were the most common interventions in the patients with persistent symptoms. Clozapine was related to better clinical improvement in the present study and it might be administered as a second-line treatment in schizophrenia.Key pointsEffectiveness of the treatment strategies in schizophrenia patients with persistent symptoms is not satisfactory to meet expectations of the clinicians yet. Clozapine still seems to be the best option to provide a favourable improvement in TRS.LAIA and oral AP combination are used frequently in schizophrenia for persistent psychotic symptoms and targets of the combination therapies in daily practice needs to be clarified.The most common intervention was transition to a LAIA (47%) in the study and none of the patients administered LAIA had used a long-acting AP before the intervention. High rate of treatment nonadherence in schizophrenia is an important reason for common LAIA preference in the patients with persistent symptoms.Growing evidence indicates that clozapine can be used as a second-line treatment in schizophrenia, and thus, there is an urgent need to increase clozapine use in the patients with persistent symptoms in clinical practice.

Chronic psychosis related to benzydamine hydrochloride abuse.

Benzydamine hydrochloride is a non-steroidal anti-inflammatory drug with analgesic and antipyretic effects. In those who use medicines containing this agent at high doses (500-3000 mg), some adverse effects such as hallucinosis, stimulant effects in the central nervous system, paranoia, and convulsions can be seen. The drug is vulnerable to abuse because of the stimulant effects on the central nervous system. In this paper, we present a young male patient with symptoms of psychosis due to benzydamine hydrochloride abuse. He was admitted to the psychiatry outpatient clinic with visual hallucinations, fear, and insomnia. His symptoms started after taking 10 tablets of benzydamine hydrochloride (500 mg) 6 months ago, which continued for 1-2 days and spontaneously resolved. The patient used high doses of the drug 3-4 times over a period of 3 months. Although his last drug intake was 3 months ago, his symptoms continued at the time of admission to the clinic. A neurologic examination and detailed laboratory tests of the patient revealed no evidence of a cause for psychotic symptoms. The patient was scheduled to undergo oral antipsychotic therapy. Although similar cases have been reported in the literature, this is the only case in which psychosis was still present despite discontinuation of the drug. Our aim was to contribute to the literature on the use of BH in causing chronic psychosis and to draw attention to the growing number of BH abuse cases.

An Occupation-Based Healthy Nutrition and Wellness Program for Individuals With Schizophrenia.

This study investigated the effectiveness of an occupation-based Healthy Nutrition and Wellness Program (HNWP) on dietary knowledge, dietary habits, metabolic values, and well-being of people with schizophrenia. Forty clients attended the HNWP once a week for 12 weeks in addition to routine treatment. Metabolic values, biochemical values, dietary habits, Healthy Nutrition Knowledge Form, and Well-being Questionnaire were measured before the HNWP, after the HNWP, and at 6-month follow-up. Repeated measures factorial analysis of variance (ANOVA) was used to compare each continuous variable and Cochran's Q test was used to compare categorical variables before HNWP, after HNWP, and at follow-up. Findings showed that HNWP increased the healthy nutrition knowledge, improved some dietary habits, increased high-density lipoprotein (HDL) cholesterol, and promoted general well-being of the individuals with schizophrenia. There was no gender difference in all variables. Inclusion of occupation-based HNWPs into treatment of individuals with schizophrenia can increase awareness about healthy life and improve their dietary habits and well-being.

Investigation of the role of personality traits and emotion regulation on personality functioning in patients with depression/anxiety disorder.

The relationship between the dimensional assessment of personality and difficulties in emotion regulation has yet to be made clear. The present study aimed to investigate the role of personality traits and emotion regulation on personality functioning. Difficulties in Emotion Regulation Scale (DERS), Beck Anxiety Inventory, Beck Depression Inventory, Personality Inventory for DSM-5 (PID-5) and Level of Personality Functioning Scale (LPFS) were rated for 220 patients with depression and/or anxiety disorder diagnosis and 100 healthy controls. Stepwise regression analyses (SRA) were used to find potential predictors of personality functioning, and generalized linear analyses (GLA) were used to find mediators between the traits and personality functioning. SRA results in the clinical group showed that higher depression, antagonism, difficulties in impulse control and difficulties in awareness predicted higher levels of dysfunction in personality. According to GLA results in the clinical group, the impulse subscale of DERS partially mediated the relationship between antagonism and level of impairment in personality functioning. Our results indicate that certain emotion regulation styles and personality traits play an important role in predicting personality functioning in the clinical sample of depression and anxiety patients. Future studies should focus on specific emotion dysregulation strategies and broaden the dimensional personality literature in different samples.

Evaluation of the Relationships between Irisin Levels and Cognitive Functions in Individuals with Schizophrenia.

Objective: : Irisin is a myokine that is involved in neurogenesis, neuronal proliferation, and neuronal differentiation. Many research examine the relationship between irisin and schizophrenia. In this study, we aimed to evaluate the relationship between irisin levels and cognitive functions in individuals with schizophrenia. Methods: : Ninety-six individuals who were diagnosed with schizophrenia were included. The Brief Psychiatric Rating Scale (BPRS) was used to assess disease severity. To evaluate the cognitive functions of the patients, the trail-making test was evaluated with the A and B forms and the verbal memory processes scale. After a 12-hour night fast, samples of fasting blood were obtained from the participants. Results: : There was no significant correlation between irisin, duration of disease, and BPRS total score. In the analysis performed, a positive correlation was found between the plasma irisin level and the error score of the trail-making test form B. Other than that, no correlation was found between irisin level and cognitive performance in schizophrenia patients. In addition, in subgroup analysis between genders, it was determined that the duration of the trail-making test B was longer in female schizophrenia patients. Conclusion: : In this study, there was a positive correlation between the trail-making test B-form error scores and the irisin levels. This relationship between impaired executive functions and irisin levels may suggest that the irisin level is increased as compensation for the impairment in executive functions. More research is needed to understand the role of irisin in cognitive impairment and schizophrenia.

Validity and reliability of the Turkish Occupational Balance Questionnaire (OBQ11-T) in mental health.

BACKGROUND: People with psychiatric disabilities often find it difficult to maintain a satisfactory occupational balance. AIMS/OBJECTIVES: This study aimed to investigate the validity and reliability of the Turkish version of the Occupational Balance Questionnaire (OBQ11-T) in mental health. MATERIAL AND METHODS: OBQ11-T was applied to 149 people for construct validity analysis and to 61 of them for reliability analysis. Validity was determined using factor analyses. The reliability of the OBQ between the first and second evaluations was assessed using the intraclass correlation coefficient (ICC) for each item and the total OBQ11-T score. Internal consistency was assessed using Cronbach's alpha. RESULTS: The results of factor analysis revealed one factor that explains 35.94% of the total variance in the model. OBQ11-T item 1 had the lowest and OBQ11-T item 4 had the highest factor loadings. The model fits the data according to the indices of relative fit (RMSEA = 0.087, CMIN/DF = 2.129, CFI = 0.901). There was an excellent correlation between test and retest OBQ11-T total scores (ICC = 0.905). All items of the OBQ11-T showed good reliability. Cronbach's alpha for the OBQ11-T total score was 0.839, indicating acceptable internal consistency. CONCLUSIONS AND SIGNIFICANCE: The current study showed that OBQ11-T is a valid and reliable tool for measuring the self-rated occupational balance of people with mental illness.

Insight in schizophrenia is associated with psychoeducation and social support: Testing a new more comprehensive insight tool in Turkish schizophrenia patients.

Insight is a continuous and multidimensional phenomenon, including awareness of having an illness, the presence of symptoms and accurate symptom attribution, the need for treatment, and the consequences of treatment. Good insight into illness is associated with better adherence to treatment, better cognitive, psychosocial, and vocational functioning along with less symptom severity, decreased relapses, and hospitalizations. Several tools are used for insight evaluation. We recruited 90 patients diagnosed with schizophrenia and analyzed the forms of 58 patients. The patients completed the VAGUS-SR (self-rated), Beck Cognitive Insight Scale, Knowledge About Schizophrenia Questionnaire, and Multidimensional Scale of Perceived Social Support (MSPSS). Clinicians performed a mental status examination and completed the Positive and Negative Syndrome Scale, Schedule for the Assessment of Insight, VAGUS-CR (clinician-rated), Calgary Depression Scale for Schizophrenia, and Clinical Global Impressions. We found that the level of insight evaluated using the VAGUS forms increased with knowledge regarding schizophrenia. Upon investigating the relationship between perceived social support and insight, we identified a relationship between VAGUS-CR and only significant other subscales of MSPSS, and between one of the VAGUS-SR scale sub-dimensions and significant other and total scores of MSPSS. Our findings also suggest that the VAGUS-SR and VAGUS-CR scales can be used to evaluate insight in Turkish populations. The positive relationship between perceived social support and insight emphasizes the importance of increasing social support through interventions aimed at improving insight. Our data also highlighted the value of psychoeducational studies in this patient group. Considering the multidimensional effects of insight on patients with schizophrenia, it would be beneficial to use scales such as VAGUS, which allow the insights of individuals to be evaluated in detail by both the clinician and the patient.

Anxiety-Promoting Parenting Behaviors in Adolescents with Social Anxiety: Controlled with a Non-Clinical Sample.

Background: : The majority of research on parenting behaviors in social phobia has been conducted with mother-child dyads, but there is still a gap in current knowledge about the role of fathers' parenting behaviors and adolescence period. This study focuses on the role of parent gender, parental attitudes, and familial factors in an adolescent population. Methods: Our study sample consisted of adolescents diagnosed with social phobia (n = 60), healthy non-clinical adolescents (n = 30), and the parents of adolescents with social phobia (n = 46) and non-clinical adolescents (n = 30). A Sociodemographic Information Form, Family Interview Inventory, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Liebowitz Social Anxiety Scale, and The Parent Attitude Research Instrument were administered to all groups. Results: The parents of adolescents with social phobia have reported a higher overprotective mothering attitude when compared to parents of healthy adolescents (P mother < .001 and P father = .009). The mothers' overprotective parenting style and the fathers' avoidance levels were found as predictive factors for adolescents' social phobia in logistic regression analysis (respectively; exp(ß) = 0.868 and P = .002; exp(ß) = 0.927 and P = .017). Conclusion: Our results indicate the necessity of considering both the parents in the research. We suggest that controlled prospective future studies on different ages, diagnostic groups, and cultures, which will take the gender of both parents and patients into account, may reveal important data on the relation between parenting behaviors and social anxiety.

The relationship of potential biomarkers with psychological resilience and post-traumatic growth in female patients with breast cancer.

While investigating psychosocial factors on resilience and post-traumatic growth draws attention, research on biological correlates is limited. We investigated the relationship between post-traumatic growth, resilience, post-traumatic stress, and potential biomarkers in female patients with breast cancer (n = 71) from the general surgery or oncology clinics. They completed the Post-Traumatic Growth Inventory (PTGI), Connor Davidson Psychological Resilience Scale (CD-RISC), Brief Resilience Scale (BRS), PTSD Checklist for DSM-V, and Hospital Anxiety and Depression Scale. Blood samples were collected for NPY, ALLO, DHEA-S, testosterone, cortisol, and hsCRP levels. The relationship between biochemical parameters and the scales was investigated in the whole patient group and in the subgroup of patients who perceived breast cancer as traumatic. When all the patients were evaluated, hsCRP and depression scores were significantly and positively correlated; and hsCRP, BRS score, and PTGI change in self-perception subscale score were significantly and negatively correlated. There was a significant positive correlation between the ALLO level and the psychological resilience (CD-RISC) score in the patient group who perceived breast cancer as traumatic. It was observed that psychological resilience and PTG were positively correlated, and that multiple biomarkers were associated with psychological resilience in female breast cancer patients. Especially findings regarding ALLO levels and psychological resilience could be a new target for future research.

Could Irisin Levels be Affected by Physical Activity in Patients with Schizophrenia?

OBJECTIVE: The aim of this study was to explore the effect of physical activity and metabolic parameters on irisin levels in patients with schizophrenia and healthy controls. METHODS: Ninety-six patients with schizophrenia and 63 healthy controls comprised the study population. The participants were separated into three groups: inactive, low activity, and sufficiently active according to International Physical Activity Questionnaire short form (IPAQ-SF). We measured irisin levels using Enzyme linked immunosorbent assay. We also calculated exercise levels by using the IPAQ-SF for each individual. The independent samples ttest was used in the data analysis to compare irisin levels according to the activity levels of the patients with schizophrenia and controls. RESULTS: The levels of irisin were higher in the healthy controls (p < 0.001) compared to schizophrenia groups. When the activity levels of the schizophrenia and healthy control groups were compared, the irisin levels of the low activity and sufficiently active groups with schizophrenia were found to be lower than those of the low activity and sufficiently active groups in the healthy controls (respectively p = 0.014; p < 0.001). CONCLUSION: Irisin levels could be affected by physical activity and these results must be supported with new studies.

[Dimensional Approach to Obsessive-Compulsive Disorder: Dimensional Obsessive-Compulsive Scale with Turkish Psychometric Properties]. / Obsesif Kompülsif Bozuklukta Boyutsal Yaklasim: Boyutsal Obsesif Kompülsif Bozukluk Ölçegi Türkçe’nin Psikometrik Özellikleri.

OBJECTIVE: The Dimensional Obsessive Compulsive Scale (DOCS) is a measurement tool that examines the severity of thematically distinct symptom domains of obsessive compulsive disorder (OCD). In this study we assess psychometric properties of the Turkish version of DOCS. METHODS: Ninety-six patients who presented consecutively to the Diskapi Yildirim Beyazit Teaching and Research Hospital outpatient unit and who were diagnosed with OCD according to the DSM-IV-TR criteria were enrolled in the study. The DOCS, Yale-Brown Obsessive Compulsive Scale (YBOCS), and Padua Inventory (PI) were completed by the participants. Internal consistency was estimated using Cronbach’s Alpha values and item-total correlations. Principal component analyses with Varimax rotation were used to assess latent factor structure . RESULTS: Explanatory Factor Analyses (EFA) revealed a 4-factor solution for the DOCS. Chronbach’s alpha values for the whole scale, “contamination” sub-scale, “responsibility” sub-scale, “unacceptable thoughts”, and “symmetry” sub-scales were 0.874, 0.932, 0.933, 0.948, 0.921, respectively. There was a high correlation between both total scores and sub-scales scores of DOCS, YBOCS and PI. CONCLUSIONS: Internal consistencies were good for the total scale and excellent for the sub-scales. The factor structure and the contents of the factors were perfectly in line with the original scale (i.e. 4 factor). Positive correlations between DOCS, its sub-scales, and similar OCD scales suggest that the DOCS accurately measures the structures it claims to assess. Thus the DOCS Turkish version can measure dimensional obsessive compulsive symptoms among the Turkish speaking OCD population.

[A comparison of implicit memory performance in mild cognitive impairment and Alzheimer type dementia patients]. / Hafif Kognitif Bozuklugu Olan Hastalarla Alzheimer Tipi Demans Hastalarinin Ortük Bellek Performansi Açisindan Karsilastirilmasi.

OBJECTIVE: Implicit memory, defined as the recollection of knowledge unconsciously, automatically, and without being aware of it, is different than explicit memory, in which knowledge is recollected consciously, while being aware of it. In the present study, the implicit memory performance of patients with mild cognitive impairment (MCI) and Alzheimer's type dementia (ATD) (different stages) were compared to healthy controls. METHOD: The study included 19 MCI patients and 23 ATD patients (11 mild-moderate and 12 severe stage ATD). Control subjects were matched to the patient groups according to age, gender, education, and hand preference. DSM-IV and NINCDS-ADRA diagnostic criteria were used for clinical assessment. RESULTS: The 4 x 3 ANOVA revealed a significant main effect of the level of processing, and group and level of processing interaction effect was also significant. Group main effect was not significant. CONCLUSION: MCI and ATD groups performed similarly on the implicit memory task. Implicit memory performance was intact in patients with MCI and ATD; however, implicit memory performance of the patient groups differed according to the level of processing manipulation. For that reason, implicit memory tasks should be used for clinical diagnosis in ATD.

Inter-rater agreement of the Turkish version of the Neurobehavioral Rating Scale-Revised form.

OBJECTIVES: This study aims to adapt the Neurobehavioral Rating Scale-revised form (NBRS-R) for Turkish traumatic brain injury (TBI) patients and to investigate the inter-rater agreement of the Turkish revised scale. PATIENTS AND METHODS: A total of 45 patients (36 males, 9 females; mean age 31.1±13.0 years; range 18 to 60 years) with TBI were included in this study between September 2013 and August 2014. A semi-structured interview was set up for Turkish patients using a multidisciplinary approach (physiatrist, psychiatrist, neurologist and psychologist) with the participation of four rehabilitation centers. Questions were prepared for each of the 29 items, based on the recommendations of the original NBRS-R form. Four different interviewers from the four centers applied this form to a total of 45 TBI patients. RESULTS: The items evaluated by intra-class correlation coefficient showed satisfactory stability and the reliability of the items ranged from moderate to very good. CONCLUSION: The NBRS-R form can be suggested to provide a reliable and easily reproducible evaluation method of neurobehavioral deficits in TBI patients who speak Turkish.

Total white blood cell count, liver enzymes, and metabolic syndrome in schizophrenia.

BACKGROUND/AIM: Metabolic syndrome (MetS) is an important clinical issue in patients with schizophrenia, but its associated factors are still ambiguous. The aim of the present study was to test whether there are any associations between MetS and white blood cell (WBC) levels, liver enzymes, or sociodemographic variables. MATERIALS AND METHODS: The study included 91 patients with a diagnosis of schizophrenia. We used the National Cholesterol Education Program's Third Adult Treatment Protocol criteria to evaluate MetS in patients. Schizophrenia patients with MetS were compared with those without MetS on the basis of demographic and clinical characteristics and total WBC counts. We conducted Spearman's correlation and binary logistic regression analyses to achieve the best prediction of MetS in schizophrenia. RESULTS: Compared with schizophrenia patients without MetS, those with MetS were older, less educated, and more likely to be smokers. They were also more likely to have a longer duration of the illness, a longer untreated period, and higher alanine aminotransferase (ALT) and WBC levels. MetS was correlated with age, duration of illness, income, ALT, gamma-glutamyl transpeptidase, WBC, and hemoglobin values. Age and WBC levels were found to be the best predictors of MetS. CONCLUSION: Hemograms and liver tests should be conducted to test for MetS in schizophrenia.

Childhood trauma and suicide risk in the population living in Zonguldak Province.

INTRODUCTION: No previous study has investigated the association between early trauma and suicidal behavior in Zonguldak. The aim of this study was to investigate the incidence of childhood abuse and neglect in the general population living in Zonguldak province and the relationship between childhood trauma and suicidal ideations and attempts. METHODS: The present study was carried out with 897 people in the general population, as assessed in a representative sample from Zonguldak province. The cluster sampling method was used. After obtaining written consent from the people who agreed to participate in the study, the Socio-demographic Information Form, Suicide Probability Scale, Childhood Trauma Questionnaire, Beck Depression Inventory, and Beck Anxiety Inventory were administered. RESULTS: The lifetime prevalence of suicidal ideations was 18.3% among those who experienced at least one type of early trauma, and it was 9.6% among those without a history of childhood trauma (P < 0.001). Only emotional abuse exhibited a significantly high odds ratio for lifetime suicidal ideations (odds ratio [OR] = 3.168, 95% confidence interval [CI] = 1.731-5.798) and attempts (OR = 3.467, 95% CI = 1.343-8.952). Emotional neglect showed a high odds ratio only for lifetime suicidal attempts (OR = 3.282, 95% CI = 1.287-8.371). There were significant correlations among the Beck Depression Inventory, Beck Anxiety Inventory, and Suicidal Probability Scale sub-scores and all six Childhood Trauma Questionnaire scores. DISCUSSION: Emotional abuse and neglect in childhood are significantly associated with lifetime suicidal ideations and attempts in the general population living in Zonguldak province. Therefore, clinicians should be aware of the importance of the childhood trauma in the patients with suicidal ideations and attempts.

[The comparison of nicotine replacement therapy and behavioral education in smoking cessation: a study of naturalistic follow-up]. / Sigarayi birakmada nikotin replasman tedavisi ve davranis egitimi yöntemlerinin karsilastirilmasi: dogal izlem çalismasi.

In this study, we aimed to compare quitting smoking rates after behavioral education (BE) and/or nicotine replacement therapy (NRT). 610 patients applied between October 1999-April 2002 have been acknowledged and evaluated by a questionnaire including demographic variables, smoking history, smoking habits and attitudes, motivation; biochemical assay and spirometric measures were examined. One-year follow-up results and demographic variables of patients who recruited to treatment (n= 435) were analyzed by chi-square, Student-t test, one-way ANOVA and post-hoc tests. 375 (66.8 %) case were given NRT and BE; only BE (Fagerstrom < 6, not want to use of NRT, medical and economic reasons) was recommended to 186 (33.2 %) case. There was not difference between NRT and BE groups with regards to age, sex, packet year, smoking beginning age except Fagerstrom score. Smoking cessation rates for 1-year were 31.5 % in NRT group, 24.2 % in BE group, and 29.1 % in whole group (x(2)= 3.19, p> 0.05). Quitting rates were similar between age, sex, education, occupation, and complaint groups. Two groups were not statistically different with regards of smoking history and nicotine dependence. The most frequent side effect was skin reactions (7 %). The economical and medical burden of smoking increase as time goes on. According to our results, NRT and behavioral education are both efficient in smoking cessation.

The Effect of Dressing Styles and Attitudes of Psychiatrists on Treatment Preferences: Comparison between Patients and Psychiatrists.

INTRODUCTION: Recently, different dressing styles and attitudes of psychiatrists have been proposed to enhance the interaction between patients and the physician. The aim of the present study was to investigate the preferences of dressing style and attitudes of a psychiatrist of the patients referred to an outpatient psychiatry clinic and the perception of psychiatrists regarding the preferences of the patients. METHODS: One hundred and fifty-three patients referred to the outpatient psychiatry clinic of the Bülent Ecevit University School of Medicine, and 94 psychiatrists have been included in the present study. RESULTS: When the images of psychiatrists were evaluated in terms of referral for treatment, trust in treatment, and willingness to share their confidential matters, both groups gave minimum scores to causal/sports dress style. While psychiatrists preferred to dress in a suit, casuals, and white coat, the preference order was white coat, casual dress, and suit in the patient group. There was a significant difference between the groups with respect to three dressing styles. CONCLUSION: It can be suggested that psychiatrists assume that patients are traditional in terms of their preference of the dressing style of a doctor and doctor-patient relationship, and a white coat is important to enhance the treatment adherence of patients.

[Comparison of body-image self-perception and BMI of dieting adolescents with those of non-dieters]. / Diyet yapan ve yapmayan ergenlerin kendilik algisi, beden imaji ve beden kitle indeksi açisindan karsilastirilmasi.

INTRODUCTION: Our main objective was to determine the relationship between body image, self-perception and body mass index in dieting adolescents and non-dieters. METHOD: 531 high-school students 15-17 years old were selected randomly and evaluated by Self-Perception Profile for Adolescents, Body Image Satisfaction Questionnaire, (BISQ) Dieting Status Measure (DiSM) and ideal body weight. Multivariate variance analysis for the effect of gender, age and dieting status on SPPA and BISQ subscales and multiple regression analysis for determining the predictors of dieting were used. RESULTS: 33% of girls of normal weight reported that they were dieting. The percentage of dieters among female adolescents was significantly higher than that among male adolescents. While female adolescents were dieting for a thinner body ideal, boys were dieting for a thinner or fatter body ideal. In the dieting groups, lower body image satisfaction and self-worth were determined the physical appearance and general self-worth domains of the SPPA were the predicting factors of body image satisfaction in both female and male groups. CONCLUSION: The percentage of girls who have a thinner body ideal and are dissatisfied with their actual body weight is considerable and is close to those in developed countries. The relationship between body image, self-perception and body mass index in dieting groups may help us to understand the psychopathology of eating disorders.

[Relationship between depression and anger in patients with antisocial personality disorder]. / Antisosyal Kisilik Bozuklugu Olan Hastalarda Ofke ve Depresyonun Iliskisi.

OBJECTIVE: This study examined the relationship between aggression and depression in male antisocial patients with and without comorbid depression and in normal control subjects. METHOD: Seventy-two antisocial patients were evaluated for depression using SCID. The antisocial patients were treatment-seeking soldiers, mostly substance use is recruited from military hospitals. The control group consisted of forty age and sex matched subjects. Twenty of these antisocial patients were diagnosed with depressive disorder (major depression or dysthymia). In order to assess aggression and depression the Beck Depression Inventory and the State-Trait Anger Scale (STAS) were used. RESULTS: Antisocial patients with depression and without depression had higher trait anger, anger-in and anger-out scores than the controls. Antisocial patients without comorbid depression had lower scores than the antisocial patients without depression in the anger control subscales of STAS. On the other hand, in this subscale, scores of the antisocial patients with depression did not differ from those of the normal controls. Correlation analysis revealed a significant positive relationship between BDI scores and trait anger, anger-in and anger-out scores. CONCLUSION: The result of our study did not fully support the view of depression which assumes that depressive disorder is related to anger and hostility at least in antisocial patients. According to our results higher anger scores and lower anger control scores were related to being antisocial rather than being depressive and also not only suppressed anger but also outwardly expressed anger were increased in depressive antisocial patients.