A comparison of health behaviours in male adolescents with and without offending histories referred for adolescent health services in Turkey.

BACKGROUND: Offending and incarceration are important societal problems that might be reduced by improving early intervention. Most prior work identifying risk factors has focussed on early oppositional or aggressive behaviours and environmental problems. Among adults, it is well recognised that offenders have much poorer health than the wider population. This raises questions about whether behaviours that put health at risk while a teenager may also be good markers of subsequent offending. AIMS: To examine the relationship between risky health behaviours and delinquency by comparing male teenage offenders with a history of incarceration and male teenagers with no criminal involvement. METHODS: In this cross-sectional study, 66 male 12-18-year-old offenders with an incarceration history who were referred for evaluation to the Forensic Medicine Polyclinic in 2021 were compared with 74 similar aged adolescents without a criminal record but attending another clinic in the same hospital, using the Risky Health Behaviour Scale (RHBS). This covers dietary, road safety and sexual behaviours as well as exercise, substance use and violent behaviours. Negative items were reverse scored so that higher scores indicated more pro-health activities. RESULTS: Total RHBS scores were significantly lower among the offender-group than the comparison teenagers (Means 93.19 ± 17.00: 107.20 ± 10.83; p ≤ 0.001). This reflected significant differences in each of the subscale scores except dietary and risky sexual behaviour. Only substance use behaviours, however, were independently related to offender group membership, as was family socio-economic status. CONCLUSIONS: Our findings add indications of risky health-related behaviours to the already extensive literature on risky social behaviours in the history of young offenders. It is possible that focussing on young offenders referred to a health service, albeit one primarily directed at mental health, has exaggerated such differences, but if substantiated in larger and more diverse samples, these findings may open new avenues for early identification of young people at risk of offending and commensurate early interventions. Focus on substance use by young people seems especially important, but low family socio-economic status needs remedies too.

Evaluation of Incest Cases: 4-Years Retrospective Study.

Incest is specific type of sexual abuse. The aim of this study was to evaluate the sociodemographic data and examination findings of cases referred to our hospital as forensic court cases of incest, and to measure the effect on mental health disorders of the nature of the sexual abuse. Retrospective examination was made of the records of 40 cases of incest victims. Evaluation was made of the age, gender, incident suffered, the perpetrator, form of abuse, examination findings, and mental status. The cases comprised 36 girls and 4 boys. Without penetration sexual abuse was determined in 25 cases and with penetration sexual abuse in 15 cases. At least one mental health disorder was determined in 20 of the cases of simple sexual abuse and in 11 of the major sexual abuse type cases. The most frequently seen mental health disorder was post-traumatic stress disorder (PTSD) in 21 cases. Mental health disorders were determined in 77.5% of the incest cases in this study, at a greater rate 80% in cases of "without penetration sexual abuse" than in cases of "with penetration sexual abuse" 74.33%. Therefore, all cases of incest must be followed up carefully without differentiation of without or with penetration abuse.

An overlooked nerve in neuropathies associated with intragluteal injections: the posterior femoral cutaneous nerve.

OBJECTIVE: The aim of this study was to investigate the frequency of posterior femoral cutaneous nerve (PFCN) lesions in patients referred to the electrophysiology laboratory with an initial diagnosis of sciatic nerve lesion following injection, and to create awareness that PFCN lesions can occur following intramuscular injections administered to the gluteal region. METHODS: Fifty-seven patients who were referred to the electrophysiology laboratory because of injection neuropathy were identified from the hospital records. In addition to the routine electrophysiological examination, PFCN sensory conduction study was performed according to the technique of Dumitru and Nelson. The scores of the Hospital Anxiety and Depression Scale (HADS) and the Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale were recorded for all participants. RESULTS: Of the 21 participants who agreed to participate in the study, 2 patients were diagnosed with PFCN lesions, one of them had isolated complete PFCN lesion, and another had it accompanied by sciatic nerve lesion. Patients with PFCN lesions had a lower body mass index and a higher HADS score than patients with sciatic nerve lesions (p = 0.01, p = 0.04, respectively). CONCLUSIONS: As correct diagnosis is the priority starting point for successful treatment, clinicians should plan examinations taking into consideration the fact that PFCN lesions can occur following gluteal region injection.

Self-Insertion of Newspaper into Bladder: An Unusual Case of Foreign Body.

Foreign bodies are most frequently observed in the bladder among the genitourinary organs. Many different foreign bodies such as needles, wires, Foley's catheter fragments, and magnetic balls have been observed in the bladder previously. In the present case, a 50-year male patient presented to the hospital with fever and acute urinary retention. Despite antibiotic therapy, the urinary tract infection did not regress, and the patient's suspicious statements were associated with the foreign body. Examination of the patient necessitated further enquiry upon the detection of newspaper pieces in the bladder. It was discovered that the patient had folded the newspaper in an attempt to commit suicide and pushed it into the bladder. Such a case has never been observed previously in the literature. An 8-cm rolled piece of newspaper was detected in the bladder using a cystoscope and was removed with open surgery. Key Words: Bladder, Foreign body, Newspaper.

The Use of Handwriting Changes for the Follow-up of Patients with Bipolar Disorder.

Introduction: Patients with bipolar disorder have motor skill deficiency and cognitive dysfunction. It is suggested that these deficiencies are related to the neurodevelopmental course of the disease. The aim of this study was to examine whether or not there was a change in the handwriting of patients with bipolar disorder in periods of mania and remission. Method: Two samples of handwriting and signature were taken from the cases, one on admission before treatment and one just after discharge. The first sample was taken in the period when the patients hospitalised with manic episode before medications and the second sample was taken in remission when the decision for discharge was made. The handwriting changes betwen the manic episode and the remission period were examined. Results: In the examination of the handwriting between the two periods, there was an increase in the size of the writing, pen pressure, the length of words, the spaces between words, and missing and incorrect punctuation marks in the manic episode. There were no differences in any handwriting measure on function of the specific diagnosis or the antipsychotic dose but tremor count was higher in patients using antipsychotics (p<0.05). Most of the parameters showing a change were found to be related to the Young Mania Rating Scale (YMRS) scores. Conclusion: The results of this study determined severe changes in the handwriting of patients with bipolar disorder in a period of mania. Handwriting features can be used to screen patients for discharge and can be used for prediction when a patient might switch into manic episode. Also intake YMRS scores were found as the most important feature that affect handwriting parameters in manic patients.

Assessment of suicide probability and related factors in male incarcerated adolescents; a sample of reformatory center in Turkey.

OBJECTIVE: Suicidal behavior in adolescents is an important public health problem, and it ranks first among the causes of prison deaths in incarcerated adolescents(IAs). The aim of this study is to determine the probability of suicide and associated risk factors in IAs. METHOD: Seventy-one male adolescents in a reformatory center were contrasted with a matched group of 71 male adolescent with no psychiatric disorder and no criminal record. Suicidal probability and psychiatric symptomatology were assessed with the Suicide Probability Scale, SA-45 Questionnaire, respectively. RESULTS: It was determined that the probability of suicide was higher in IAs, and depression and hostility symptoms, the presence of another individual involved in delinquency in family had predictive effects. It was also found that there was a positive correlation between the probability of suicide and the number of delinquencies, the number of incarceration, and a negative correlation between attending to school or work while in reformatory and being visited by relatives while in reformatory. CONCLUSIONS: The results suggest that when assessing suicide risk for IAS, it may be useful to pay attention to those with symptoms of depression or hostility, those with multiple delinquencies or entrance to reformatory, and those who have family members involved in delinquency.

The Relationship Between Suicide Attempt and Gonadotropins, Gonadal Hormones, and Cortisol in Females.

Objective: The aim of this study was to examine the relationship between suicidal behavior and gonadotropins, gonadal hormones, and cortisol in females. Methods: The study included 3 groups of 23 females each, aged 18-45 years; one group comprising those who had attempted suicide, another group of females matched for age, menstrual phase, and body mass index, with depression but no suicidal tendencies, and a control group of 23 healthy females. For all participants, a sociodemographic information form was completed, and the Beck Depression Inventory, the Beck Anxiety Inventory, and the Beck Hopelessness Scale were used. Blood samples were taken at 8 am (in the attempted-suicide group, within 24 hours of the attempt), and follicle-stimulating hormone, luteinizing hormone, estradiol, testosterone, progesterone, and cortisol levels were measured. Results: No statistically significant differences were observed between the groups with respect to gonadotropin and gonadal hormone levels. There were statistically significant differences in the cortisol levels between the attempted suicide and control groups and between the depression and control groups (P < .05). The cortisol levels negatively correlated with all scale scores. Conclusion: Studies on suicidal patients should pay more attention to the potential role of hypocortisolism. More studies with larger samples are needed to investigate the relationship between gonadotropins, gonadal hormones, and suicidal behavior.