No Interaction Between Childhood Maltreatment and Serotonin Transporter Gene in Recurrent Major Depressive Disorder: A Clinical Sample.

INTRODUCTION: There is inconsistent evidence of interaction between childhood adversities and a serotonin transporter promoter polymorphism (5-HTTLPR) in depression. It is hypothesized that genetic sensitivity to stress could be more specific to recurrent major depressive disorder (MDD). The aim of the study is to replicate a recent study which provided preliminary evidence of interaction between severity of childhood maltreatment and the 5-HTTLPR polymorphism in recurrent MDD. METHODS: Participants included a well-characterized clinical sample of 70 recurrent MDD cases and 67 never psychiatrically ill controls, aged 18 years or over. Socio-demographic and clinical information form, Composite International Diagnostic Interview (CIDI), Childhood Trauma Questionnaire (CTQ), Beck Depression Inventory (BDI) were applied to both groups, along with genotyping. RESULTS: There was no interaction between childhood maltreatment and the 5-HTTLPR in relation to recurrent MDD. All forms of childhood maltreatment were reported as more severe by cases than controls, and there was an independent association between maltreatment and recurrent MDD. CONCLUSION: The path forward to detect genetic risk loci for depression remains challenging. Taking childhood maltreatment history into account could lead to a richer understanding of differences in biological correlates, genetic underpinnings, and outcomes.

The relationship between traumatic childhood experiences and proclivities towards substance abuse, self-esteem and coping strategies.

OBJECTIVE: The aim of this study was to compare people with substance use disorder with healthy controls in terms of childhood abuse, proclivity towards substance abuse, coping skills and self-esteem as well as the correlation between experiences of abuse in childhood and these variables. METHOD: The study group included 41 subjects diagnosed with substance use disorder, who had been sentenced under the respective laws as a result of crimes relating to substance use and possession, and the control group. A sociodemographic Data Form, SCID-I, Childhood Trauma Questionnaire, COPE, Substance Abuse Proclivity Scale and Rosenberg Self-Esteem Scale were applied to all participants. RESULTS: Childhood trauma history was observed to be more common in the study group than in the control group. When the childhood trauma questionnaire was evaluated, the scores for physical abuse were found to be significantly higher in the study group. COPE subscale scores for mental disengagement, focusing on problems and expressing emotions, active coping, coping through religion and emotional social support usage were significantly lower in the study group. The study group's results on the Substance Abuse Proclivity Scale were found to be higher than those of the control group. On the Rosenberg Self Respect Scale, the study group's scores were higher while the control group was more likely to have high self respect. CONCLUSION: People with substance use disorder are more likely to have a childhood history of physical abuse, higher proclivity towards substance abuse and lower self esteem. The level of abuse increases the level of emotion-based coping while decreasing levels of problem-based coping. There is support for the view that that traumatic childhood experiences are one of the psychosocial risk factors related to, although not specific to substance use.

Psychosocial aspects of living-related donor renal transplantation: Quality of life and mood in recipients, donors and controls.

Due to the high frequency of living-related donor renal transplantation (LRDRT) in our country, we were concerned both about the recipient and the donor quality of life and psychological well-being. We investigated HRQL and mood in LRDRT recipients, donors, and controls using the Beck Depression Inventory, Beck Anxiety Inventory, and 36-item Short Form Health Survey. The recipient group consisted of 69 individuals who underwent renal transplantation between August 2002 and June 2004. The donor group consisted of 35 and the control group 45 healthy individuals. Multivariate analysis of variance and the post hoc (Tukey) test were used to assess and to analyze differences among and between the three groups. The depression scores of the recipients were higher than donors (P < 0.05) but were similar to controls. The recipient scores indicated poorer physical functioning (P < 0.001), greater physical limitation on roles (P < 0.001), and lower levels of general health (P < 0.01) compared to controls. The donor scores indicated higher vitality (P < 0.01), better social functioning (P < 0.05) and greater mental health (P < 0.01) than controls. Poorer health and mood status among the recipient group might reflect the various negative impacts of chronic debilitating disease. It is therefore recommended to screen recipients regularly for clinically relevant HRQL impairments after transplantation.

Factitious cheilitis: a case report.

INTRODUCTION: Factitious cheilitis is a chronic condition characterized by crusting and ulceration that is probably secondary to chewing and sucking of the lips. Atopy, actinic damage, exfoliative cheilitis, cheilitis granulomatosa or glandularis, contact dermatitis, photosensitivity reactions and neoplasia should be considered in the differential diagnosis of crusted and ulcerated lesions of the lip. CASE PRESENTATION: We present a 56 year-old female with an ulcerated and crusted lesion on her lower lip. The biopsy showed granulation tissue and associated inflammation but no malignancy. Based on the tissue examination and through clinical evaluation the diagnosis of factitious cheilitis was rendered. CONCLUSION: Thorough clinical history, utilization of basic laboratory tests and histopathologic evaluation are required to exclude other diseases and a thoruough psychiatric evaluation and treatment is vital for successful management of these patients.

[Psychiatric and psychosocial aspects of chronic renal failure]. / Kronik böbrek yetmezliginin psikiyatrik ve psikososyal yönleri.

Primary treatment modalities of chronic renal failure (CRF) are dialysis and renal transplantation. According to 1997 data there were 10,000 hemodialysis and 1893 continuous ambulatory peritoneal dialysis (CAPD) patients in Turkey. On a yearly basis 360 renal transplantation procedures take place. In deciding for one of the treatment modalities, medical criteria are of partial importance. On the other hand, in terms of psychosocial adjustment and functioning and quality of life, even the expert clinicians emphasize that is very difficult to predict which treatment modality is best for the patient. While some researchers report that psychiatric morbidity and disability of CRF are high and there is no difference between the chosen treatment modalities, most of them report that transplantation is more advantageous than dialysis, and quality of life is better in transplant patients. On the other hand, some researchers claim that psychological adjustment varies during the treatment of CRF and psychiatric symptoms decrease with time. In this paper, psychiatric and social problems in CRF and the effect of these problems on quality of life are reviewed. According to our literature review covering the past 30 years, there have been many researchers for the CRF patients' psychosocial difficulties. Also most of this research work compare treatment strategies with respect to psychiatric morbidity and quality of life.

[Narcissistic personality disorder and factitious disorder on a borderline personality organization basis: a psychoanalytic psychotherapy process]. / Sinir kisilik organizasyonu temelinde narsisistik kisilik bozuklugu ve yapay bozukluk: psikanalitik psikoterapi süreci.

The aim of this presentation is to summarize the changes occurring during the psychoanalytic psychotherapy of a dystonic (due to anoxic injury), 25-years-old female patient both from the standpoint of diagnosis and dynamics as well as the changes occurring in the therapist. The patient was finally diagnosed as having narcissistic disorder with factitious traits on a borderline personality organization and was twice hospitalized for a wide variety of symptoms, such as suicidal attempts, auditory and visual hallucinations, animistic thoughts, obsessive compulsive symptoms, dissociative episodes, and fear of abandonment. Hospitalized treatment was started on a weekly basis. Avoidance of interpretation, acceptance of her fantasies, outbursts and hostile behaviour helped the patient to reveal herself as a helpless and lonesome person trying to get attention with pseudo-symptoms created throughout the therapy. The patient finally established a trusting relationship with the therapist. This, in turn helped the therapist to become more attuned to the patient's difficulties. It is obvious that establishing a positive working relationship is the basis of psychotherapy and that even on a once a week basis significant changes can occur in a patient's attitude towards his/her life and future. Another point emphasized in this paper is the importance of supervision, which helped the therapist to overcome prejudices and become more flexible.