Comparison of the sociodemographic, clinical and offense-related data of delusional disorder patients with and without a criminal history.

This study investigates the relationship of delusional disorder and its subtypes to criminal and violent behavior by comparing the sociodemographic and clinical characteristics of patients with and without a criminal history and identifying predictors of crime. The records of 346 patients with a delusional disorder diagnosis were retrospectively evaluated using a sociodemographic data form, a crime violence rating scale and the Overt Aggression Scale (OAS). The results show that homicide and attempted homicide were committed more frequently by patients with jealous delusions, whereas verbal assault and crimes against the public were committed more frequently by patients with persecutory and other delusions. Patients with a criminal history had more hospital admissions and longer stays. Marital status, persecutory delusions, a high OAS score and older age were found to be associated with higher risk of crime. Clinical subtypes and sociodemographic characteristics seem to discriminate delusional disorder patients' risk of crime.

Psychiatric Comorbidity, Sexual Dysfunction, and Quality of Life in Patients Undergoing Hemodialysis: A Case-Control Study.

INTRODUCTION: Due to disabilities caused by the disease and the requirement of dialysis, end-stage renal disease (ESRD) is frequently comorbid with psychiatric disorders, adversely affects quality of life, and causes significant sexual dysfunction (SD). We aimed to investigate the psychiatric comorbidity, quality of life, depression and anxiety levels, and SD in ESRD patients undergoing hemodialysis. METHODS: Forty-nine patients undergoing hemodialysis treatment in a dialysis center and 44 non-ESRD control subjects selected with snowball sampling were enrolled in the study. All subjects were assessed using Structured Clinical Interview for Axis-I Disorders (SCID-I). Sociodemographic data form, Hospital Anxiety and Depression Scale (HADS), Arizona Sexual Experience Scale (ASEX), and World Health Organization Quality of Life Short Form Turkish Version Scale (WHOQOL-BREF-TR) were applied to both groups. RESULTS: There was no difference between the groups in terms of sex, age, education period, marital status, presence of additional physical illness, and past history of psychiatric disorders. Compared with the control group, HADS depression subscale and ASEX scores were significantly high (p<0.01) in the patient group, and WHOQOL-BREF-TR psychological and physical domain scores were low (p<0.05 and p<0.01, respectively). There was a significant negative relationship between HADS scores and WHOQOL-BREF-TR psychological, environmental, and national environmental scores in the patient group (p<0.05). When the differences between the groups were re-analyzed after controlling HADS depression scores with covariance analysis, the significant difference in ASEX and WHOQOL-BREF-TR physical domain scores between the groups remained, but the significant difference in WHOQOL-BREF-TR psychological domain scores disappeared. CONCLUSION: The quality of life of ESRD patients was lower, especially in the psychological and physical domains, and psychiatric comorbidities and SD rates were higher than in non-ESRD control subjects. Quality of life is affected by SD. Recognizing and treating depressive symptoms will help improve the quality of life, especially in the psychological domain.

[Clinical Characteristics of Malingering Among Arrested and Convicted Male Cases That are Sent for Treatment]. / Tedaviye Gönderilmis Tutuklu ve Hükümlü Erkek Olgularda Hekimi Yaniltici Davranisin Klinik Özellikleri.

OBJECTIVE: The study is done to investigate the predictive variables of malingering among arrested/convicted cases and the clinical characteristics of malingerers. METHOD: The study includes 70 arrested/convicted male cases internalized for their treatment. Aform to collect clinical or sociodemografic data, Structured Clinical Interview for DSM-IV Disorders (SCID I), Structured Clinical Interview for DSM-III-R (SCID II), Symptom Check-list (SCL-90-R) and Rey Memory Test (RMT) are applied. Two independent psychiatrists, without being part of the study diagnosed malingering. RESULTS: Arrested cases reported mostly psychotic like and convicted cases mostly depression like symptoms. RMT is helpful by malingering and SCL-90-R psychotic symptom and paranoid symptom subscale scores were both correlated negatively when compared to the RMT scores by malingerers. Axis-I or Axis-II diagnosis were found out to be more predictive than other clinical variables to determine malingering. CONCLUSION: This study indicate that clinicians have to take malingering into account especially by arrested and convicted cases applied for treatment and they have to be careful by doing the differential diagnosis. Large sample studies conducted with arrested and convicted cases and surveys by grouping cases according to the expertise and treatment services may provide additional data related to malingering.

Attentional Bias and Training in Social Anxiety Disorder.

Cognitive behavioral therapy (CBT) is one of the most effective treatment modalities for social anxiety disorder (SAD), showing a high level of clinical evidence supporting its effectiveness. On the other hand, lack of the desired benefit from this treatment in some patients causes continuation of the search for new techniques. Recent research studies have focused on attentional bias and attention training in SAD. Attention processes in SAD have been a major target of interest and investigation since the introduction of the first cognitive models explaining SAD. In the first model, it was highlighted that attention was self-focused. The relationship between threatening stimuli and attention was considered in the subsequent models. Attentional bias towards threat may take place in several ways, such as facilitated processing of threat, difficulty in disengaging attention from the threat and avoidance of attention from the threat. After these descriptions regarding the phenomenology of the disorder, treatments to modify attention, processes were developed. In spite of conflicting results, investigations on attentional training are promising. Attention processes, attentional bias and attentional training in SAD are discussed in this review.

The Validity and Reliability of the Turkish Version of Miller Forensic Assessment of Symptoms Test (M-FAST).

INTRODUCTION: The aim of this study was to show the validity and reliability of the M-FAST Turkish Version. METHODS: Translation and back-translation of the M-FAST was done, then the M-FAST Turkish Version was created with linguistic equivalence. The study was performed with 97 detainees and convicts sent from penal institutions who were internalized at our hospital forensic psychiatry service. M-FAST Turkish Version was applied to evaluees and as a result of clinical interview according to DSM-IV-TR diagnostic criteria and various data explorations the evaluee was examined for malingering. To investigate the internal consistency of the scale, Cronbach's alpha and test-retest methods were used. In order to check the validity of the scale, in addition to the clinician's diagnosis, participants were requested to fill the Minnesota Multiphasic Personality Inventory (MMPI) F and K validity scales. RESULTS: The mean age of participants was 31.8±9.3 (SD) years. 47 evaluees (48.5%) were diagnosed as malingering. In the internal consistency analysis, Cronbach's alpha Coefficient was found to be .93. Test-retest relationship that was applied to 22 evaluees was found to be highly significant and strong (r=.89, p<.001). M-FAST scores were significantly high at the malingering group (n=47) (z=-8.02, p<.001). ROC curve analysis suggested a score of ≥7 points as the optimal cut-off for a malingering level for the M-FAST. Kappa coefficients of malingering ± groups were found to be, M-FAST≥7 Kappa: .83; F>16 Kappa: .29; F-K>16 Kappa: .30. For diagnosis of malingering, M-FAST Scale and the MMPI inventory scales were evaluated with the Binary Logistic Regression analysis and only M-FAST scores were found to be significant in prediction of malingering. CONCLUSION: The findings of this study support that, M-FAST Turkish Form represents the structure of the original scale and can be used as a reliable and valid instrument.

[ADHD in adult psychiatric outpatients: prevalence and comorbidity]. / Ayaktan psikiyatri hastalarinda dikkat eksikligi ve hiperaktivite bozuklugu: yayginlik ve estanilar.

AIM: This study aimed to investigate the prevalence of attention-deficit/hyperactivity disorder (ADHD) in adult psychiatric outpatients. Moreover, comorbid psychiatric diagnoses in adults with ADHD were determined. Patients with and without ADHD were compared regarding DSM Axis I-II comorbidity and sociodemographic characteristics. MATERIALS AND METHODS: The study included patients that presented for the first time to a psychiatric outpatient clinic during a 3-month period and were evaluated for adult ADHD. A sociodemographic form, Wender Utah Rating Scale, Turgay's Adult ADD/ADHD Evaluation Scale, Structured Clinical Interview I and II, Symptom Check List-90-R, and Beck Depression Inventory were administered. RESULTS: The study included 246 patients. Among the 39 patients diagnosed with ADHD, 25 were female (64.1%) and 14 were male (35.9%), and the mean age was 27.38 ± 8.3 years. The prevalence of ADHD in adult psychiatric patients was 15.9%. Adults with ADHD usually presented due to comorbid psychiatric problems; major depression (43%), generalized anxiety disorder (23%), and obsessive-compulsive disorder (17%) were the most common comorbid diagnoses. Substance abuse (58.9%) and attempted suicide (38.5%) were among the most prevalent psychiatric problems. CONCLUSION: The present findings show that ADHD is an important comorbidity in adult patients that present to psychiatric clinics, and may cause serious mental health problems or complicate mental illness.

Geriatric psychiatry consultations in a Turkish university hospital.

OBJECTIVE: The size of the elderly population is growing rapidly in Turkey. We aimed to characterize geriatric psychiatry consultations to obtain the characteristic pattern of these patients for further interventions. METHOD: A retrospective chart review was undertaken for each patient. RESULTS: One hundred and sixty-six patients with a mean age (+/- S.D.) of 75.5 +/- 6.6 years were included in this study. Most referrals came from the Department of Internal Medicine (42.2%), with sleep problems (42.1%), depression (29.5%) and anxiety (28.3%) being the most common reasons for referral. Hypertension was the most frequent medical diagnosis (53.6%). The mean number +/- S.D.) of medications used by each patient was 4.4 +/- 2.0. The leading psychiatric diagnosis at the end of the assessment was adjustment disorder (31.3%). CONCLUSION: Turkish geriatric psychiatry consultation patients display similar characteristics to elderly patients from other western countries. The main difference comes from diagnosis of adjustment disorder, which may be related to hospital conditions and strong family ties in developing countries.