[Show abstract][Hide abstract] ABSTRACT: Objective:
To overview and evaluate the main findings, methodological shortcomings, and time trends of the recent psychiatric epidemiology studies in Turkey, as well as to provide areas prone for development in forthcoming research.
PubMed and Turkish Psychiatry Index were screened to identify relevant studies. Any epidemiological study from 2000 to 2012 with a general population or unique sub-population sample was included. Papers and results were classified as depression, anxiety, psychotic, dissociative, conversion, personality, alcohol and substance abuse, and trauma-related disorders, and common geriatric disorders.
There are various epidemiological studies on various psychiatric disorders in Turkey. However, there are main shortcomings and trends in research that subsequently stagnate current psychiatric epidemiological research. First, epidemiological studies were mainly conducted for academic purposes, not for addressing epidemiological issues or issues of health policy. Second, studies mainly focused on particular fields and institutions, which led to non-systematic accumulation of epidemiological results. Third, although Turkey is a natural laboratory of social conflicts and disasters, there were few studies with a focus on probable outcomes. Fourth, high-quality epidemiological studies with disseminating results tended to decrease, even in common mental disorders such as depression. Fifth, there were very few epidemiological studies using contemporary designs such as follow-up, genetic, or biomarker data in the general-population.
Although psychiatric epidemiological studies of the last decade provide a suitable ground for future challenges, current trends in this research area has tended to stagnate, despite the potential for unique contributions. Forthcoming studies and researchers may notice novel methodological developments in epidemiology, with a growing attention on rapid urbanization, natural disasters, social conflicts, and migration.
Full-text · Article · Dec 2014 · Turk psikiyatri dergisi = Turkish journal of psychiatry
[Show abstract][Hide abstract] ABSTRACT: Different methods are used to understand the suicidal mind. Suicide note analysis may be most direct way to do this.
To study the content of suicide letters under forensic evaluation in terms of psychological and cognitive aspects.
A total of 51 letters were referred to The Council of Forensic Medicine from different cities of Turkey and analyzed by a research group with ten members including forensic medicine specialists and psychiatrists. The Questionnaire of Content Analysis of Suicide Letters (The Q-CAS), developed by researchers, was used to analyze the cognitive and cultural themes of suicide letters. The cognitive distortions about the self, the world, and the future as well as cultural phenomena were evaluated including sociodemographic features.
Financial problems in males and relationship problems in females were the most frequent life events related to suicide. Hopelessness, weakness, loneliness--in decreasing order--were the most predominant cognitions and emotions. The total score of females were higher than that of males (p=.002).
These negative cognitions should be taken into consideration when therapeutic interventions are planned on individuals with suicidal thoughts.
No preview · Article · Feb 2012 · Crisis The Journal of Crisis Intervention and Suicide Prevention
[Show abstract][Hide abstract] ABSTRACT: It has been suggested that the treatment strategy needs to be reviewed and changed if depression occurs in patients with posttraumatic stress disorder (PTSD). We analyzed data extracted from the Marmara Epidemiological Survey (MES) which had examined 683 survivors at 3 years after a devastating earthquake. Fifty three cases (40.5%) out of the 131 cases with PTSD had also been diagnosed with MDD. Comorbid PTSD and MDD group has significantly lower rates of recovery from PTSD in comparison to PTSD without MDD (26.4% vs. 47.4% respectively). Rates of past psychiatric disorder and past traumatic experience were significantly more frequent among the comorbid group. Moreover, comorbidity of PTSD and MDD was clearly associated with greater psychological distress, more severe PTSD, and diminished perceived social support. Past psychiatric disorder, General Health Questionnaire (GHQ-12) and Multidimensional Scale of Perceived Social Scale (MSPSS) total scores succeeded in predicting the comorbidity of PTSD and MDD significantly.
No preview · Article · Nov 2010 · Community Mental Health Journal
[Show abstract][Hide abstract] ABSTRACT: To determine the prevalence of Criterion A traumatic events and current posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) in prisoners in Kocaeli Closed Prison.
The study was conducted in Kocaeli Closed Prison in Turkey. The sample consisted of 30 female and 30 male prisoners who had been in prison for at least 1 month. The PTSD and MDD section of the Structured Clinical Interview for DSM-IV and the Traumatic Events Screening Instrument for Adults were used by experienced clinicians.
Most (n = 52, 86.7%) participants reported lifetime exposure to at least 1 Diagnostic and Statistical Manual of Mental Disorders (4th ed.) PTSD Criterion A event. Although the August 17, 1999, earthquake was the most prevalent traumatic event (n = 31, 51.7%), it was not related to the risk of current PTSD in prisoners. Current PTSD was rare among men (n = 2, 6.7%) and women (n = 3, 10%) but more prevalent than in community surveys of adults. Traumatic events that were relatively unique to the incarcerated population (e.g., committing murder) were identified. Moreover, 17% of women (n = 5) and men (n = 5) were diagnosed with MDD. Traumatic events that had the strongest conditional probabilities of association with a diagnosis of PTSD and MDD were identified.
Exposure to traumatic stressors was highly prevalent among prisoners. Ongoing interpersonal traumatic events were particularly likely to be experienced as traumatic and related to PTSD and MDD, and violent criminal acts may be highly traumatic for the perpetrator.
No preview · Article · Oct 2010 · Journal of Trauma & Dissociation
[Show abstract][Hide abstract] ABSTRACT: Some studies have found elevated alexithymia among patients with chronic pain, but the correlations between alexithymia and the severity of pain, depression, and anxiety among migraine patients are unclear. The aims of the present study were to investigate whether individuals suffering from episodic migraine (EM) differ from those with chronic migraine (CM) in regards to depression, anxiety, and alexithymia measures and to investigate the association of alexithymia with the results of depression and anxiety test inventories and illness characteristics.
A total of 165 subjects with EM and 135 subjects with CM were studied. The Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Toronto Alexithymia Scale (TAS) were administered to all subjects. The correlation between alexithymia and sociodemographic variables, family history of migraine and illness characteristics (pain severity, frequency of episode, duration of illness) were evaluated.
Compared with EM patients, the CM patients had significantly higher scores on measures of depression but not alexithymia and anxiety. There was a positive correlation between TAS scores and age and education in both migraine groups, but there was no correlation between TAS scores and other demographic variables. Depression and anxiety were significantly correlated with alexithymia in both migraine groups.
Our results indicate that CM patients are considerably more depressive than EM patients. In this study, depression and anxiety were significantly correlated with alexithymia in both migraine groups. Our results demonstrate a positive association between depression, anxiety, and alexithymia in migraine patients.
Full-text · Article · Jun 2010 · Psychiatry and Clinical Neurosciences
[Show abstract][Hide abstract] ABSTRACT: On 3 January 2008 explosives placed in an automobile on a thoroughfare in Diyarbakir, southeastern Turkey exploded in a terrorist attack. The aim of this study was to determine the risk factors for the diagnosis of and the rate of post-traumatic stress disorder (PTSD) among individuals who were eye- or earwitnesses to the explosion 1 and 3 months after the explosion.
Among the residents and workers in close proximity to the explosion site, 216 individuals who were eye- or earwitnesses to the explosion were included in the study. A sociodemographic data form and a traumatic stress symptom scale were administered to the participants 1 and 3 months following the explosion.
In all, 12.5% of the participants were diagnosed with PTSD 1 month post-explosion versus 9.6% 3 months post-explosion. While history of psychiatric disorder and physical injury were risk factors for PTSD 1 month post-explosion, risk factors 3 months post-explosion was history of psychiatric disorder.
PTSD occurs at high rates in individuals exposed to terrorist attacks. More studies following such events are required in Turkey. In light of these results it is advised that individuals at risk of PTSD receive therapeutic and preventive interventions provided by mental health professionals.
Full-text · Article · Feb 2009 · Turk psikiyatri dergisi = Turkish journal of psychiatry
[Show abstract][Hide abstract] ABSTRACT: Objectives: The purpose of this study is to learn more about general practititoners' knowledge, attitudes and social distance towards depression which is the most prevalent mental disorder seen in general practice. Method: The survey was conducted in 2002 using face-to-face interviews in offices of 300 general practitioners in Turkey. Data were derived from the questionnaire developed for the survey called "Attitudes Towards Mental Disorders". Results: Almost all of the practitioners believed that depression was treatable, and it could be completely cured according to 90% of the respondents. 80% of the practitioners considered "extreme sadness", near half of them "weak personality" and more than 90% "social handicaps" to be as the causes of depression. 66% believed that these patients would not improve unless social problems were solved. Attitudes of the subjects with relatives diagnosed depression, married, and older were more positive than the others with respect to social distance characteristics. Discussion: Although general practitoners with closer social distance held more positive attitudes towards depression than community people, the results suggest that incorrect knowledge and beliefs about etiology, nonmedical treatment methods and risk of dependency have a tendency to persist in this group. The results of this study underline the need for development of new education programmes aimed to decrease effects of stigmatization based upon information obtained more studies about attitudes and beliefs of physicians.
[Show abstract][Hide abstract] ABSTRACT: Objective: Worldwide, cancer is the second most frequent cause of death after the ischemic heart disease. Lifetime prevalence of psychiatric co-morbidities in cancer patients is 30-40%. Major depression is the most prevalent psychiatric disorder in patients with cancer. Major depression has a negative effect on quality of life, self-care, treatment compliance, prognosis, and treatment response of the cancer patient. In this study, we evaluated the prevalence of major depression in patients with cancer and the related factors which might affect this co-morbidity. Methods: Hundred patients with cancer (53 men and 47 women) who attended to oncology outpatient units were recruited to the study. Participants were assessed with 'Structured Clinical Interview for DSM-IV (SCID) - Mood Disorders Module' and 'The Questionnaire for the Assessment of Patients with Cancer'. Results: The prevalence of major depression in patients with cancer was 22%. The prevalence of major depression was higher in women than in men. Insomnia was found in 50% of patients. Insomnia was recognized in 20% of patients with breast cancer and 15% of patients with lung cancer. Suicidal ideation was found in 11% of the patients with cancer. The prevalence of suicidal ideation increased with age and it decreased as the disease progressed. Conclusion: Major depression is a frequent psychiatric problem in the patients diagnosed with cancer. By reason of frequency, early recognition of major depression and the related factors will provide appropriate treatment. The frequency of suicidal ideation is even important in this population. Psychosocial support and psychiatric treatment approaches should be the focus of further attention in oncology clinics.
No preview · Article · Jun 2008 · Anadolu Psikiyatri Dergisi
[Show abstract][Hide abstract] ABSTRACT: Objective: The diagnosis and treatment of cancer can be an extremely stressful and traumatic experience. Cancer has been recognized as a traumatic event capable of precipitating posttraumatic stress disorder (PTSD) in DSM-IV. However, recent researches have showed that many positive and negative psychosocial outcomes might follow cancer diagnosis and treatment. Evidences suggest that cancer might precipitate both PTSD and posttraumatic growth, at times within the same individual. In this study we investigated the prevalence of PTSD and posttraumatic growth in a sample of cancer patients. Method: Hundred patients diagnosed with cancer (53 women and 47 men) who attended to oncology outpatient units were randomly recruited to the study. PTSD is assessed with "Structured Clinical Interview for DSM-IV (SCID) - PTSD Module" and posttraumatic growth is assessed with "Stress Related Growth Scale". Findings: Although 19% of the sample met diagnostic criteria for PTSD, there was not any statistical significance between diagnosis of PTSD and sociodemographic variables such as gender, age, and marital status, level of education, occupation, social support, residential area and having a child. Treatment with chemotherapy and PTSD was significantly correlated. Suicidal thoughts were detected in 11% of the patients, although there was no patient with the history of suicide attempt. Mean posttraumatic growth score was 124.1±22.8 and there was not any significant association between posttraumatic growth score and the ages and gender of the patients. Religious belief either increased or stayed the same in 80% of patients. Most of the survivors indicated that their spirituality and faith assisted them throughout the cancer experience. Discussion: The presence of PTSD in cancer survivors may influence the clinical outcome. Early recognition of PTSD in the patients diagnosed with cancer is important for ensuring timely and appropriate clinical interventions. Nevertheless, many cancer survivors experience positive growth as they adjust to changes brought about by their illness. In particular, religious beliefs and spirituality provide patients diagnosed with cancer with important tools for coping with their illness. Conclusion: Future research is required to develop better clinical interventions in the management of either PTSD or posttraumatic growth in cancer survivors.
[Show abstract][Hide abstract] ABSTRACT: The serotonin syndrome develops as an acute adverse reaction due to serotonergic hyperactivity. The characteristic triad of serotonin syndrome includes mental status changes, autonomic dysfunction, and neuromuscular abnormalities. There are no laboratory tests to confirm the diagnosis. Treatment should start with discontinuation of the precipitant agent. We hereby present a brief review of the syndrome, implicated drugs and its suggested treatment algorithm.
No preview · Article · Jan 2008 · Neurology Psychiatry and Brain Research
[Show abstract][Hide abstract] ABSTRACT: Psychiatric symptoms are commonly seen in the course of chronic hepatitis B and C virus infections. Because of the higher comorbidity of alcohol and substance use disorders, active participation of psychiatrists are required with crucial importance in the management chronic hepatitis patients. The management of such patients requires a multidisciplinary approach and consultation-liaison psychiatrists play an important role in this teamwork. Nowadays, there has been no consensus regarding the therapy of chronic hepatitis patients with psychiatric disorders. In the recent guidelines, the presence of depression and alcohol use disorders prior to antiviral therapy causes up to 6 months delay of the therapies; therefore, detailed psychosocial evalution is offered before the treatment of chronic hepatitis. If a psychiatric disorder of a patient with chronic hepatitis is missed and not treated, patients compliance to antiviral therapy will be affected negatively, and may worsen the progress and prognosis of the disease. In this review, we aimed to evaluate the prevalence, physiopathology, relationship with interferon and treatment of psychiatric symptoms seen in patients with chronic hepatitis, based on the recent studies.
No preview · Article · Jan 2008 · Anadolu Psikiyatri Dergisi
[Show abstract][Hide abstract] ABSTRACT: Capgras Syndrome is a rare delusional misidentification syndrome where the patient thinks that someone, to whom he/she has strong emotional attachments, has been substituted by a "fake" person who looks identically the same. The exact roots of CS have not been elucidated; however, organic etiologies such as, B12 deficiency and structural abnormalities were identified. Because CS is usually observed in the presence of a psychiatric disorder, it is difficult to isolate and analyze the underlying organic etiologies. From this perspective, we present a CS case with a diagnosis of delusional disorder and an underlying B12 deficiency who showed significant clinical improvement with B12 replacement and 30 mg per day aripiprazole therapy. Based on our findings, it can be suggested that B12 levels should routinely be checked in CS patients and taking different etiologies into consideration and including them within the treatment plan can increase clinical success.
No preview · Article · Jan 2008 · Neurology Psychiatry and Brain Research
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to determine the prevalence of posttraumatic stress disorder (PTSD) in parents of children with cancer. Five questionnaires were administered to 104 parents, including a sociodemographic questionnaire, a traumatic events check list, the Structured Clinical Interview for DSM-IV PTSD and Major Depressive Disorder modules, and the self-rating instrument General Health Questionnaire-12. The prevalence of PTSD was 34.6%. The statistically significant tendency to develop PTSD were found in the female gender, better educational status, death of a loved one, previous history of psychiatric disorder, having a child with poorer prognosis, and the presence of radiotherapy in child's treatment. The vulnerable parents must receive psychosocial support.
No preview · Article · Jan 2008 · Pediatric Hematology and Oncology
[Show abstract][Hide abstract] ABSTRACT: The objective of this study was to determine the prevalence of sexual dysfunction in patients with schizophrenia under antipsychotic therapy and to investigate the effect of various parameters on sexual dysfunction.
A total of 827 stabilized outpatients who met DSM-IV criteria for schizophrenia, were recruited in the study. Arizona Sexual Experience Scale (ASEX) and the subscale on sexual function of the UKU Side Effects Rating Scale were applied at a single interview.
In total, 52.6% of the patients had sexual dysfunction, 54.2% reported a low sexual desire and 41.7% reported problems in having an orgasm. Erectile dysfunction and ejaculation problems were seen in 48.1% and 64.2% of the men, respectively; amenorrhea was seen in 24.9% of the women. ASEX score and severity of disease were found to be correlated (p=0.02). Higher ASEX scores were observed in patients who smoked (p=0.01). Men receiving atypical monotherapy had lower ASEX scores than those receiving a combination of atypical and conventional antipsychotics (p=0.017). Patients on combination therapy had more ejaculation problems than the atypical group (p=0.001). Low sexual desire was more prevalent among women using conventional drugs than those on atypical drugs (p=0.004). In linear regression analyses, ASEX was affected significantly and independently by the severity of the disease only in men (p=0.005).
Our results show that sexual dysfunction is widespread among patients with schizophrenia on antipsychotic medications.
No preview · Article · Aug 2007 · European Psychiatry
[Show abstract][Hide abstract] ABSTRACT: Objective: This study evaluated the clinical and sociodemographic features associated with concurrent Axis I psychiatric disorders among adult psychiatric outpatients with panic disorder (PD) with or without agoraphobia (AG). Method: This was a retrospective chart review study of 12.980 patients treated for any psychiatric disorders in psychiatric outpatient clinics. Diagnoses of comorbid disorders were determined in a sample of 478 patients with panic disorder as defined in DSM-IV. The subjects were divided into two groups: patients panic disorder with AG (n=221) and panic disorder without AG (n=254). Sociodemographic variables, illness characteristics such as symptoms, duration of illnes and family history of psychiatric disorders were evaluated. Results: Panic disorder was prevalent among 3.7 % of the sample. The most common Axis I psychiatric disorders among groups were major depressive disorder (21.7 %) and generalized anxiety disorder (8.9 %). The prevalence of other psychiatric disorders in present study was as follows: social phobia 7.3 %; obsessive-compulsive disorder 4.6 %; posttraumatic stress disorder 4.6 %; eating disorders 1.46 %; alcohol abuse/dependence 4.6 %; somatoform disorders 0.85 %; bipolar disorder 0.6 %; dysthymic disorder 2.3 % and impulse control disorder 0.4 %. Female subjects have higher comorbid conditions compared to males. Those with more concurrent Axis I conditions had longer histories of PD and younger age of onset.
No preview · Article · Jan 2007 · Neurology Psychiatry and Brain Research