Early relapse of psychotic symptoms after an initial response to olanzapine.

This is a report of two cases with schizophrenia in which a good response to olanzapine in an acute 6-week treatment phase was obtained, followed by early relapse without any clear contributing factors. Referring to a few other case reports of early relapse after an initial response to atypical antipsychotics other than olanzapine, the possibility is discussed that rapid displacement of these drugs due to loose binding could play a role in early relapse.

Gender differences in the prevalence of depression: a survey in primary care.

Epidemiological surveys demonstrate that unipolar depression is more common in females than in males. Gender-specific cultural and social factors may contribute to the female preponderance. This study explores this possibility in a cross-cultural sample of general-practice patients systematically recruited in the WHO study "Psychological Problems in Primary Care" conducted in 14 countries with identical sampling and assessment strategies. Although absolute prevalence rates are broadly varying between centers proposing that the gender ratio is nearly constant with 1:2. The cultural context does not contribute substantially to the female preponderance. This study lends some support to previous observations that the magnitude of female preponderance is associated with the number of symptoms associated with depression requested for caseness and inversely related to the degree of social impairment. Matching social role variables (marital status, children, occupational status) between females and males reduces the female excess by about 50% across all centers. Therefore, we conclude that social factors are inducing part of the preponderance of females among depressed cases.

General Health Questionnaire (GHQ12 & GHQ28): psychometric properties and factor structure of the scales in a Turkish primary care sample.

The General Health Questionnaire is a widely used screening instrument. It detects a wide range of psychological disorders, mainly the anxiety/depression spectrum, and has been shown to be a valid and reliable instrument across cultures. This study reports the psychometric properties of the 12- and 28-item versions of the questionnaire among Turkish primary care attenders, focusing mainly on the factor structures. Both questionnaires were found to be reliable and they had factor structures consistent with the original studies.

Pathways to psychiatric care in Ankara.

This paper describes the pathways that patients take to reach psychiatric services in Ankara. A total of 582 patients were seen in a calendar month in seven centres, two of them being child psychiatric clinics. The pathway in Ankara, unlike may other centres in Europe, is dominated by direct referrals. Only 4% of patients in our sample contacted their general practitioner (GP) first, compared with 42% who first saw hospital doctors and 53% who came direct. Religious healers appeared in the pathway of only 1% of patients, and the delay associated with them was longer. Male patients had longer delays than female patients, and delays were also longer for patients presenting with somatic symptoms. Although the availability of psychiatric services is limited, the median time taken to be seen by the psychiatric services after contacting any carer was only 1 week. The results showed that the referral system for the mental health services is still far from a GP-based system. The patients presenting with somatic symptoms consulted hospital doctors more frequently and were delayed more, pointing to the need for the training of hospital doctors, in addition to GPs, in the recognition and management of common psychiatric disorders.