Objective: The aim of this study was to compare depression and anxiety levels and the effects of psychiatric variables on the sexual satisfaction in natural and surgical menapause. Method: Thirty six natural menapause and 35 surgical menapause women attended to this study in Department of Gynecology and Obstetrics, Pamukkale University. Psychological outcome was measured by using the Hamilton Depression Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A) and satisfaction of sexual assesment using the Golombock Rust Inventory of Sexual Satisfaction (GRISS). Results: Hamilton depression test results were (natural and surgical menopause) 7.91 5.83, 8.11 6.88; Hamilton anxiety test scores (natural and surgical menopause) 14.93 10.36, 13.49 10.58). The two groups did not differ in HAM-D, HAM-A and GRISS (p>0.05). We found a correlation between anxiety-depression levels and sexual satisfaction in surgical menopause (p<0.05). Conclusion: This study suggested that menapause associated with mild level anxiety and depressive symptoms may lead to sexual dissatisfaction and this relationship was more prominent in surgical menapause group. Our results implied that the clinicians may consider the presence of psychological distress and sexual dissatisfaction of menopausal women.

Amaç: Psikiyatri servisinde yatan hastaların izleminde etkileşime dayalı standardize ölçeklerin kullanılması bir yandan hizmet kalitesini, bir yandan da hastalara ayrılan zamanı artırabilir. Bu çalışmada tüm maddelerinin etkileşimle doldurulmasıyla diğer standardize ölçeklerden ayrılan Psikiyatri Servisinde Yatan Hastalar için Etkileşimsel Gözlem Ölçeği'nin Türkçe geçerlik ve güvenirlik çalışması yapılmıştır. Yöntem: Otuz dört yatan hasta dört tane hemşire ekibi tarafından bir ay boyunca izlenmiştir. Ekibin bir üyesi hastayı günlük olarak izlerken, diğer üye haftanın belli günleri hastayı değerlendirmiştir. Toplam 717 adet ölçek doldurulmuştur. Hastalar bir psikiyatri hekimince haftada bir BPRS (Kısa Psikiyatrik Değerlendirme Ölçeği) ile değerlendirilmiştir. Bulgular: Ölçeğin görüşmeciler arası güvenirliğini değerlendiren sınıf içi korelasyon katsayısı 0.84 olarak bulunmuştur. Ölçek toplam puanının BPRS puanıyla korelasyonu 0.55'dir. Ölçeğin alkol bağımlılığı olan hastalar dışında öngörücü geçerliliğe sahip olduğu gösterilmiştir (Kesim noktası=3, Duyarlılık= % 73.7, Özgüllük= %73.9). Bu kesim noktasında pozitif öngörme gücü %64.6 olarak bulunurken negatif öngörme gücü %80.8 olarak hesaplanmıştır. Ölçeğin Türkçe formunun sosyal ilgi, psikotizm ve irri- tabilite/psikomotor ajitasyon olarak adlandırılan üç faktöre sahip olduğu gösterilmiştir. Sonuç: Psikiyatri Servisinde Yatan Hastalar İçin Etkileşimsel Gözlem Ölçeği'nin affektif ve psikotik hastalığı olan bireylerin psikiyatri servisinde yatışları sırasında tedavilerinin izlenmesi ve tedaviye yanıtlarının değerlendirilmesinde kullanılabilecek güvenilir bir ölçek olduğu söylenebilir.

In spite of our increasing knowledge about the pathophysiology of depression and the mechanisms of antidepressant treatments, there are some unmet clinical needs like the high rate of lack of response to antidepressants, and the time lag before the action of conventional therapeutics. Thus, preclinical studies still have primary importance in this area of research. Animal models are widely used in medical studies which are impractical or impossible to be carried on human, and they have significant implications in search of new and better antidepressant treatment strategies. In this article, animal models of depression which are widely used in preclinical studies are reviewed. These models have certain issues to be resolved about validity, like many other animal models for other psychiatric disorders. Some of these models are solely used for screening new molecules for antidepressant action, while some are designed to model certain aspects, symptoms, of depression in human. In this article tail suspension test, forced swimming test, models of learned helplessness and psychostimulant drug withdrawal are reviewed. In addition, few etiological models like chronic mild stress and social stress which are based on the theoretical role of stress in pathophysiology of depression are discussed. For practical reasons, rodents are preferred in most of these models. With the advances in genetic technologies, animal models have made important contributions in our insights on depression and its treatment. Refinement of better animal models may result in findings which will inspire further preclinical and clinical studies in depression.

In 1940-60s patients diagnosed with borderline personality disorder were considered as "preschizophrenic" and so, impossible to be treated with psychoanalysis, rather a more supportive approach was recommended. Kernberg's seminal theoretical work in 1970s that defined borderline personality organization marked a watershed in the approach to treatment and interpretative techniques came back to the ascendancy. In 1980s, there was a return to the old idea and even a tentative list of criteria describing the types of patients who are at the greatest risk for a negative or lack of response to treatment was made. There are few reasons for the discussions about the efficacy of psychotherapy for borderline personality disorder. Firstly, it is extremely important to note that these patients form a heterogenic group so it seems wiser to talk about a 'borderline spectrum', rather than the strict criteria of DSM system. The studies about the efficacy of psychotherapy for borderline patients have contradictionary results. The main reason for this is that; studies have used different treatment settings and measuring methods, and clinicians prefer to use their own psychodynamic view. The purpose of this report is to summarize the psychoanalytically oriented psychotherapy of a borderline patient and discuss some important issues about psychotherapy with this group of patients in the light of recent literature.

The patients who request sex change operations separates two groups. There are transsexual patients in the first group. The patients in the second group are gender dysphoria patients. The second group is larger and has indefinite borders. Transsexualism can be defined as refusing one's anatomical gender and desiring to have primary and secondary gender characteristics of the opposite sex. The identification with the opposite gender is constant in transsexualism. The onset of transsexualism is in childhood. Transsexual patients are rare. Gender dysphoria syndrome is a clinical syndrome like transsexualism in which there is an impropriety between the anatomical gender and identity gender of a person. Transsexualism is the most serious form of gender dysphoria syndrome and it is in the most extreme point of the syndrome. It is an infrequent case to see gender dysphoria syndrome alone and permanent. Most of gender dysphoria patients have axis I diagnoses of DSM-IV (psychotic disorders, affective disorders). Besides, subthreshold forms of psychosis, psychopathologies of character, major developmental problems frequently associate with gender dysphoria syndrome. The course of the syndrome fluctuates (exacerbations and remissions). In this syndrome, the diagnosis of primer psychiatric disorder and the relation of the syndrome with this disorder is important for the appropriate treatment and prognosis. In this report a gender dysphoria patient with comorbid obsessive-compulsive disorder who responded to sertraline and risperidone treatment is presented.

There is a close relationship between alcohol dependency and psychotic disorder since alcoholism was found in schizophrenic individuals four times more than the normal population, and temporary hallucinations and delusions were detected in 43% of alcohol dependent individuals. Alcoholic hallucinosis is a clinical process, which continues generally with live hallucinations. Auditory hallucinations are the ones, which are threatening, frightening and scaring the individual in quality. They are perceived as talking of a third person. Alcohol hallucinosis arises in individuals whose alcohol dependency was started at early ages, alcohol consumption is more than other alcohol dependents and in the ones who face more frequently alcohol related life difficulties. In the possible pathophysiological mechanisms, there are dopaminergic transmission and other neurotransmitter changes, increased beta carbolin level, and auditory system deficits. Despite the good prognosis of the picture, 10-20% of the cases were stated as becoming chronic. Alcohol hallucinosis takes attention as a clinical picture, which is seen rarely, has pathophysiological mechanisms that are not detected exactly, and whose differencial diagnosis must be well done. An alcohol hallucinosis case, which is thought to be seen rare in clinical practice, was presented.