ISSN 1302-0099 | e-ISSN 2146-7153
TURKISH JOURNAL CLINICAL PSYCHIATRY - Turkish J Clin Psy: 10 (3)
Volume: 10  Issue: 3 - 2007
RESEARCH ARTICLE
1. Determining of the Effects of Depression on Quality of Life in Patients with Tuberculosis in Active, Inactive and Control Groups
Demet Ünalan, Mustafa Baştürk, Ferhan Soyuer, Osman Ceyhan, Ahmet Öztürk
Pages 113 - 124
Objectives: The purpose of this study is to determine the levels of quality of life (QOL) and the rates of depression in outpatients with tuberculosis in active, inactive and control groups and to study the relationship between depression and QOL. Methods: This defining type study includes 196 active and 108 inactive cases with tuberculosis who applied to the dispancery for tuberculosis in one year and 196 healthy control groups. A questionnaire form, SF-36 quality of life scale and Beck Depression Invantory (BDI) are used in study. Results: It was determined that the scores of the control group were higher than those of the individuals in the patient groups, in all aspects of QOL. The average of BDI score of the active and inactive cases were found to be significantly higher than control group (p<0.001). The ratio of depression is 44.9 % (beck cut off £ 18) in the patients with active tuberculosis and 41.6% in the patients with inactive tuberculosis. It was found that there was a significantly negative relationship between BDI score and SF-36 health status dimensions (p<0.05). In logistic analysis, as physical role limitations, energy/liveliness, social functionality, emotional role limitations and mental health of QOL increases in active cases and social functionality and mental health increases in inactive cases, the possibility of depression score being 18 and more decreases with a rate of 0.001. Conclusions: Inactive cases are also affected with respect to QOL and depression, as well as active cases, and it is found that there was a significant relation between these two variables.

2. Clinical Interview Method at Determine to Domestic Violence
Özge Doğanavşargil, Işıl Vahip
Pages 125 - 136
Objectives: Findings on the prevalence of domestic violence vary greatly between studies. These differences between findings about domestic violence prevalence showed that there are procedural problems about research of issue. There is no standard to determine the real frequency of domestic violence. Till now, self report method is mostly used in studies about to domestic violence. Questionnaire forms and scales that are used are cheaper and easier to apply and can be applied to many people. But clinical interview method is more specific and more detailed than questionnaire. In this study, we aimed to compare self-report questionnaire and clinical interview that used to determine to prevalence of domestic violence. Method: For this study, 100 married women who applied to Outpatient psychiatry Clinic of Aegean University Medical Faculty for the first time were evaluated. The patients were left alone in the room one by one and they filled out the domestic violence questionnaire. After that, they were clinically interviewed by using SCID I and Semi-structured Domestic Violence Clinical Interview. Results: Life time prevalence of domestic violence was found 62% in clinical interview. Only 51% reported physical abuse in the self report questionnaire. Statistical difference between the two methods was significant (Chi Square Test, P=0.001). Conclusion: Clinical interview is the best method to determine domestic violence and psychiatric interview is the best suitable occasion.

REVIEW
3. Traumatic Stress in Relief Workers
Banu Yılmaz
Pages 137 - 147
Trauma response can be produced by indirect, as well as direct, exposure to an event. In other words, traumatic events may cause stress reactions on witnesses, relatives and friends of the victims, and relief workers, besides the direct victims of the event. In the related literature, the stress reactions of these groups are called secondary traumatic stress or vicarious traumatization. The terms secondary traumatic stress or vicarious trauma are defined as the stress reaction of those who witness or have the knowledge of a traumatic event, or who are involved in the relief operations. The psychological effects of being involved in relief operations are investigated in many studies. When the stressors of emergency work are considered, it can be inferred that emergency workers may show stress reactions similar to that of direct trauma victims. The purpose of this article is to present the traumatic stress in relief workers within the framework of research findings on vicarious trauma and secondary traumatic stress. The research on secondary traumatic stress and posttraumatic stress reactions in relief workers were reviewed in the related literature; and research findings were presented within the framework of predictors of stress symptoms in this group. Research reviewed reveals that there were several variables predicting the traumatic stress vulnerability of the vicariously traumatized individuals. It is crucial to improve the preventive interventions in these groups in order to reduce the negative effects of continuous exposure to traumatic incidents. Therefore, variables related to secondary traumatic stress and the relations of these variables need to be determined to develop culture-specific models appropriate for these groups.

4. Psychiatric Aspects In Temporomandibular Disorders and Bruxism
Nurper Erberk Özen
Pages 148 - 156
Temporomandibular disorder (TD) is a common disorder and a term used to describe a number of related disorder affecting temporomandibular joint, masticatory muscles and associated structures, all of which have common symptoms such as pain and limited mouth opening. Generally the patients who complaint chronical facial pain, headache, tinnitus and painful temporomandibular joint movements, first seek the care of specialists in general dentistry, general practioners, neurology, physical therapy, anesthesiology or psychiatry. There are different views about etiology of TD. Psychogenic dimensions of chronic pain have been known for a long time. There is still a controversion that TD should be either included as a somatoform or somatization disorder or not. It is generally suggested that the treatment options must be in a multidisciplinary manner. Bruxism is a motor disorder associated with grinding and gnashing of the teeth that increases with stres. Although it has been reported in related literature that symptoms of TD increase with bruxism, the relation between two still remains controversial. However, it is concluded that the psychogenic factors are important in patients with TD. In this review, general information about TD and bruxism, psychogenic dimension of chronic pain, comorbid psychiatric diagnosis and current treatment methods are discussed with the light of previous literature. For this purpose, besides the textbooks with classical general information, PubMed and Google search engines were used and terms such as "temporomandibular joint, temporomandibular disorder, pain (chronical), somatisation, bruxism" were chosen as key words. As conclusion, this article emphasizes the importance of establishing accurate diagnosis and managing interdisciplinary approach to the patients who suffer from TD and related symptoms such as bruxism and orofacial pain.

5. When Is Polypharmacy Rational In Psychiatric Diseases?
Canan Uluoğlu
Pages 157 - 170
Rational pharmacotheraphy primarily considers monopharmacy and aims to treat patients in an effective and reliable way based on evidence, with a minimum number of drugs and at the lowest cost. While investigating the sign of evidence in drug choice, it is inevitable for doctors to use some sources such as (1) World Health Organization's essential list of drugs and national drug formulary, (2) national and international guidelines, (3) randomised controlled clinical trials, meta analyses and, (4) personal clinical experiences. Although rational pharmacotheraphy aims monopharmacy, the use of polypharmacy in the treatment of psychiatric diseases is common and it was shown that polypharmacy increased up to 30-40% in the last 20 years. Since we do not have any sufficient evidence concerning the effectiveness and reliability of polypharmacy, it seems that doctors use their own clinical experiences more than evidence. "Rational polypharmacy" is based on the selection of the most useful drug combinations for patients considering drug-drug interactions and the cost of treatment. It will be conformable to evaluate special factors related with (1) the drugs (2) patients (3) the disease in order accept polypharmacy as a rational application. Taken together, it will be warranted for practitioner to avoid from prescribing the combinations of the drugs which were not shown to be efficient and reliable and, to prefer the drugs which they have the best knowledge about and, to update their information.

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