The Effect of Violence on the Diagnoses and the Course of Illness Among Female Psychiatric Inpatients.

INTRODUCTION: The aim of the study was to determine the rate of exposure to domestic violence among female inpatients at any period of their lives; to investigate the effect of different forms of violence on the diagnoses and the course of the illness. METHOD: The study was conducted on 102 female inpatients treated at Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was administered and socio-demographic and clinical data was collected. A form designed for the assessment of violence was used to evaluate domestic violence. RESULTS: Ninety patients reported that they had been subjected to some kind of violence at some period of their lives. The parents or husbands were the most frequently reported persecutors. Seventy-three patients reported that they had been subjected to violence before the onset of their illness. Seventy-one had been subjected to physical, 79 to verbal, 42 to sexual, 52 to economic violence, and 49 to constraints on social relationship formation. Comorbid diagnosis of post traumatic stress disorder (PTSD) was related to all types of violence. The rate of suicide attempt was found to be significantly related to verbal-emotional violence. Only 12 patients had previously reported being subjected to domestic violence to their psychiatrist. CONCLUSION: Domestic violence, an often overlooked phenomenon, is prevalent among women with psychiatric disorders. Subjection to domestic violence is found to be correlated with PTSD and suicidal attempt.

[Demographic and clinical characteristics in schizophrenia: a multi center cross-sectional case record study]. / Sizofrenide Nüfus ve Klinik Ozellikler: Cok Merkezli Kesitsel Bir Olgu Kayit Calismasi.

OBJECTIVE: The aim of the present study is to assess the relationship between demographic characteristics and suicide attempts, physically aggressive behavior, substance abuse, repeated hospitalizations, and continuous illness course . METHOD: The medical records of patients from three different treatment centers were assessed. The relationship between demographics and clinical characteristics were assessed. Logistic regression analysis was conducted to determine the predicting factors for suicide attempts, physically aggressive behavior, heavy smoking, repeated hospitalizations, and continuous illness course. RESULTS: The medical records of a total of 720 patients with schizophrenia were assessed. Of these patients, 68% were never married, 56% were unemployed, and 69% were living with their parents. 35% of the patients had a relative diagnosed with a psychotic disorder. The mean age for the onset of the illness was found to be 23.5, with no difference between females and males. 50% of the patients had had repeated hospitalizations. The duration of untreated psychosis was 10.8 months and 28% of the patients had been through a continuous course of the illness. 57% of the patients were found to be regular smokers; 55% of the patients had physically aggressive behavior; 52% had experienced a suicidal ideation and attempt; 28% had made at least one suicide attempt. The percentage of patients having had a legal issue related to their illness was 11%. Heavy smoking was predicted with the continuous illness and male gender. Physically aggressive behavior was predicted with suicide ideation and attempts, being single, having insufficient family support, and having undergone frequent hospitalization. Repeated hospitalizations were predicted with suicide attempts and having a legal problems; continuous course of illness was predicted with being unemployed and lack of family support; suicide attempt was predicted with duration of the illness. CONCLUSION: When both sexes were compared, the lack of difference at the onset of disease between the two suggests that there might be other factors playing a role in this phenomenon. The relationship between suicidal ideation and behavior and physical aggressive behavior, indicates that these two might share common underlying mechanisms. Possible significant relationships between demographic and clinical characteristics should be kept in mind for the prevention, treatment, and rehabilitation approaches in dealing with schizophrenia.

[Relatives' knowledge and opinions about schizophrenia]. / Sizofreni Hastalarinin Yakinlarinin Hastalikla Ilgili Bilgi ve Görüsleri.

OBJECTIVE: The aim of the present study was to determine the knowledge and opinions of schizophrenic patients' relatives regarding the disorder, its causes, treatment methods, and treatment outcomes, as well as to determine the variables that affected their knowledge and opinions. METHOD: Data were collected by contacting 332 family members living with schizophrenia outpatients that were treated in 2 different healthcare institutions. A questionnaire form was administered to collect data from the family members regarding demographic features, patients' clinical features, and family members' knowledge of the diagnostics of schizophrenia. The questionnaire also contained 22 statements regarding the etiology, treatment methods, and treatment outcomes of schizophrenia. The data were compared in relation to the demographic features of the relatives and the clinical features of the patients. RESULTS: Most of the family members (62%) referred to the disorder as schizophrenia or psychosis, and 17.5% did not know the name of the disorder. Family members thought schizophrenia was a brain disorder (87.7%), a psychological disorder (95.9%), or a personality disorder (67.5%). All participants agreed with the statement, "medical treatment must be followed". Magical attributions were believed to be involved in the disorder's onset and its treatment by 27.7% of the participants; this belief was correlated with level of education. Duration of the disorder, number of hospitalizations, existence of another psychotic patient in the family, level of education of the family members, and gender were significant predictors for their opinions. CONCLUSION: Clinical features of the patients and demographic features of the family members have a significant effect on the family members' knowledge and opinions. Outcomes of the present study could be used in the development of psychoeducational programs.

[Social skills training in psychosocial therapy of schizophrenia: a multicenter study for symptom management and medication management modules]. / Sizofreninin ruhsal-toplumsal tedavisinde sosyal beceri egitimi. Belirtilerle basetme ve ilaç tedavisi yaklasiminin türkiye'de cok merkezli bir uygulamasi.

OBJECTIVE: It is known that psychosocial skills training programs increase the efficacy of schizophrenia treatment. The aim of this study was to carry out the Turkish version of two modules of a commonly used program, Social Skills Training (Medication Management and Symptom Management Modules), and to determine its possible benefits. METHOD: The study was carried out at three sites. Fifty schizophrenic patients who were at least literate and who did not have language problems or organic mental diseases, aged 18-60, using antipsychotic agents in a standard dose and in a stable phase were included in the study. Eight training groups were formed. Each group consisted of 5-7 individuals and the study took approximately eight months. The Brief Psychiatric Rating Scale, the Quality of Life Scale: an instrument for rating the schizophrenic deficit syndrome, the Drug Treatment Compliance Scale and Pre- and Post-Tests of Social Skills Training were applied to the patients before and after the group education The scores of the rating scales were compared. RESULTS: Thirty-eight (76%) patients completed the study. The mean age of the patients was 32 +/- 7, 84% were men, 58% had received less than 11 years, of education 84% had never married, and 97% were living with their families. The mean age of illness onset was 20 +/- 5 years, and the mean duration of the illness was 12 +/- 7 years. At the end of the study, the Brief Psychiatric Rating Scale scores (baseline 42.0, after the training 37.1, p<0.02), and the Quality of Life Scale scores (baseline 67.5, after the training 75.3, p<0.01) were significantly changed. The level of knowledge of the patients about the medication and symptoms of schizophrenia increased 20.6%. Drug treatment compliance had also increased by the end of the study. CONCLUSION: The results show that this program contributed to the treatment compliance and treatment efficacy in schizophrenia. Increased treatment efficacy might have played a role in increasing of the quality of life a long with the group milieu. It may be concluded that this social skills training program, which did not encounter any problems in application, may contribute significantly to the treatment of schizophrenia.