RESEARCH ARTICLE | |
1. | Polipharmacy in Schizophrenia and Other Psychotic Disorders: The Role of Long-acting Antipsychotics Uğur Hatıloğlu, Hasan Karadağ, Serkan Akkoyunlu, Olga Güriz, Akfer Karaoğlan Kahiloğulları, Sibel Orsel Pages 101 - 107 Objectives: There is limited data on the effects of long acting drugs on antipsychotic polypharmacy in the treatment of schizophrenia in litherature. Our study is aimed to find the prevelance and the risk factors of inpatient antipsychotic polypharmacy. Method: The records of 561 inpatients treated in 2008 were examined and 261 patients diagnosed schizophrenia and other psychotic disorders were enrolled. Sociodemeographic, clinical data and the predictors of antipsychotic polypharmacy were evaluated by descriptive and logistic regression statistics. Results: Antipsychotic polypharmacy rate is 50,2% in the whole sample. 44,2% (n=52) of this group was "typical and atypical antipsychotic" combination. Polypharmacy incidence was higher in currently unemployed, previously diagnosed, longer duration of disorder and drug use groups. Treatment compliance was statistically lower as 21,4% in polypharmacy group. Referral type, rehospitalization in the same year, duration of hospitalization were similar between groups. Use of long- acting antipsychotics and number of previous hospitalization were predictive factors of polypharmacy in logistic regression analyze. Conclusion: In our study the results of long-acting antipsychotics and higher hospital- iztion numbers as predictors for polipharmacy might assign to treatment resistance and low response rate. On the other hand low response rate and treatment resistance of schizophrenia warrant more integrated treatment approaches. |
2. | Psychometric Properties of the Turkish Version 20 Item Toronto Aiexithymia Scala: According to Cut-off Score Hüseyin Güleç, Aynil Yenel Pages 108 - 112 Objectives: In the present study, literature survey and discussion on the features of the structure and continuity and categorical manifestation of the properties of primary and secondary aiexithymia have been made and the Turkish version of the twenty- item Toronto Aiexithymia Scale (TAS), which was developed by Bagby et al., was studied to determine the cut-off score in order to be allowed to assess the presence of aiexithymia. Method: This study was conducted in Erenköy Mental Research and Training Hospital Psychiatry Clinic. A total of 100 consecutive outpatients who applied to the outpatient clinic were enrolled to the study. In addition to the 20 and 26-item-TAS, a socio-demographic data collection form was used for all research participants. According to 26-item-TAS analysis, it has two cut-off scores: "1 0" and "11". Determination of cut-off score was calculated for each point separately. Results: 84 participants were female and the mean (±SD) ages of patients in the study group were found to be 26.41 ±1.15. According to "1 0" and "11", scores designated in the TAS- 26, "51" and "59" were found to be appropriate scores for the lower value and top score for TAS-20 respectively. Conclusion: If the elope of alexithymics is not wanted, "51" should be taken as the lower score; if a study with pure alexithymic group is required, it will be appropriate to take " 59" as the top score (according to "59" points designated forTAS-26). |
3. | Temperament and Character Features of Subjects with Antisocial Personality Disorder According to Criminal Profile Murat Erdem, Barbaros Özdemir, Cemil Çelik, Adem Balıkçı, Türker Türker, Kamil Nahit Özmenler Pages 113 - 118 Objectives: It was determined that the Antisocial Personality Disorder subjects with violent criminal behavior were different from Antisocial Personality Disorder subjects without violent criminal behavior in sociode- mografic characteristics and aggression levels. The aim of this study is to investigate temperament and character traits of Antisocial Personality Disorder subjects with and without violent criminal behavior. Method: 26 Antisocial Personality Disorder subjects who were evaluated 0-2 and 28 Antisocial Personality Disorder subjects who were evaluated 3-4 levels according to Taylor's violence rating scale constitute low violence group and severe violence group. Temperament and Character Inventory scores of both groups of Antisocial Personality Disorder subjects and healthy control subjects who were matched for age and education level to Antisocial Personality Disorder group were compared. Results: In temperament dimensions of Temperament and Character Inventory, severe violence Antisocial Personality Disorder group have higher scores in novelty seeking and lower scores in harm avoidance and reward dependence than low violence Antisocial Personality Disorder group and control group. In character dimensions of Temperament and Character Inventory severe violence Antisocial Personality Disorder group have lower scores in self directedness than control groups and lower scores in cooperativeness than low violence of Antisocial Personality Disorder and control groups. Conclusion: It was evaluated that severe violence Antisocial Personality Disorder subjects differed from low violence Antisocial Personality Disorder subjects in temperament and character dimensions. This difference is concurrence with results of previous studies. |
4. | Investigation of Relationship Between Ward Atmosphere and Treatment Motivation in Patients with Dependence Ayşegül Savaşan Pages 119 - 126 Objectives: Ward Atmosphere is an important element which decreases or increases terapeutic efect of other treatment methods. Treatment motivation has been viewed as a crucial element promoting client responsiveness to treatment and favorable treatment outcomes. In this descriptive study, it's aimed to investigate the relationship between treatment motivation and perceptions of ward atmosphere. Method: The study was conducted with 82 patients who hospitalized in the Alcohol and Drug Research, Treatment and Education Center in Izmir. Data was collected with Personal Information Form, Treatment Motivation Questionnaire (TMQ) and Ward Atmosphere Scale-Form R. Results: Ward Atmosphere Scale point means were 6.5±2.01 for Involvement; 8.23±1.63 for Support; 4.84±1.23 for Spontaneity; 4.57±1.38 for Autonomy, 7.54±1.57 for Practical Orientation; 5.29±1.7 for Personal Problem Orientation; 3.17±1.5 for Anger and Aggression, 8.79±1.21 for Order and Organization, 7.46±1.14 for Program Clarity; 7.34±1.13 for Staff Control. TMQ point means were 49.31 ±5.83 for Internalized Motivation; 11,26±2.95 for External Motivation; 23.59±4.37 for Interpersonal-helpseeking; 21.34±3.372 for Confidence-in-treatment; 1 05.52±11.22 for total motivation for treatment. There is a positive correlation between personal problem orientation and internalized motivation, interpersonal- help-seeking, total motivation for treatment. There is a positive correlation between spontaneity and internalized motivation, total motivation for treatment. Also, there is a positive correlation between autonomy and external motivation; between program clarity and confi- dence-in-treatment. Discussion: Developing personal problem orientation and spontaneity and interventions for program clarity will increase motivation for treatment. |
5. | The Relationship Between Family Dysfunction and Psychological Symptomatology: The Meditating Role of Early Maladaptive Schemas Emine Gül Kapçı, Zeynep Hamamcı Pages 127 - 136 Objectives: In the last decade, identification and modification of basic cognitive structures which were named with core beliefs or schemas by different theoreticians, have been emphasized in cognitive-behavioral therapy. Young, the founder of schema focused approach, proposed the Early Maladaptive Schemas as the deepest level of cognition, and Early Maladaptive Schemas refer to extremely stable and enduring themes that develop during childhood and elaborated upon throughout an individual's lifetime. Young argued that psychopathology arises from the development and maintenance of the Early Maladaptive Schemas. Most of chronic patients have more than one of these core schemas. The present study aimed to examine the hypothesis that Early Maladaptive Schemas serve as a mediator variable in the relationship between family dysfunction and psychological symptoms. Method: A total of 352 university students (female=241; male=111) filled in self-report instruments of the Family Assessment Device, the Brief Symptom Inventory and the Young Schema Questionnaire-Short form. Results: Regression analyses demonstrated that family dysfunction predicted emotional isolation, impaired limits, insufficiency and fair- responsible-anxious sub-schemas of the the Young Schema Questionnaire. In turn, these four schemas were found to predict psychological symptoms as measured by the Brief Symptom Inventory. Only the emotional isolation subscale of the Young Schema Questionnaire was found to serve as a mediator variable between the family dysfunction and psychological symptomatology. Conclusion: Findings were discussed in relation to cognitive therapy, family dysfuntion and the relationship between Early Maladaptive Schemas and psychological symptomatology. |
REVIEW | |
6. | Occupational Therapy (Ergotherapy) Alev Büyükkınacı Pages 137 - 142 The aim of this review is to introduce occupational therapy for rehabilitation of chronic mental disorders like schizophrenia which is speeding up in Turkey and to define applications of occupational therapy in Europe and America by using published papers on this issue. For that reason, how occupational therapy started and developed,how long education for occupational therapy lasts and what it contains and the studies published on this issue are investigated and outlined For this review, published books on occupational therapy were used and the studies published on this issue were scanned by using pubmed and medline. Fort this scanning, 'occupational therapy1 and 'ergotherapy' key words were used. Occupational therapy is an old and widely used instrument for rehabilitation in neurology, orthopedics, reumatology, child diseases, psychiatry and geriatrics in Europe and United States.The main aims of occupational therapy are to help patients join daily life activities and to use these activities for rehabilitation. In the process of occupational therapy, evaluation, occupational therapy diagnosis, planning, application and reevaluation services are offered. Despite the minor differences between countries, education of this profession lasts 3-4 years. And the studies published on its applications showed that occupational therapy contributes the improvements in social area. It seems, is important to make appropriate interventions to use occupational therapy in rehabilitation field in Turkey as soon as possible for both patients with chronic mental disorders and the future of rehabilitation applications. |
CASE REPORT | |
7. | EMDR: A New Choice of Treatment in Fibromyalgia? A Review and Report of a Case Presentation Önder Kavakçı, Ece Kaptanoğlu, Nesim Kuğu, Orhan Doğan Pages 143 - 151 Fibromyalgia syndrome (FMS) is a nonarticular rheumatic disease with unknown etiology and is characterized by widespread pain, increased tenderness in some anatomical regions, increased pain sensitivity, sleep disorders, fatigue and frequently by psychological distress. Psychiatric comorbidity is high in FMS and reports denoting to relationship of FMS and psychologial trauma have increased recently. We aimed to assess whether or not a treatment modality concerning trauma can alleviate symptoms of FMS. One of the FMS patients who was admitted to the outpatient department of Physical Medicine and Rehabilitation was randomly assigned to the present study. After that, assessed whether patients's traumatic experiences, and the Eye Movement Desensitization and Reprocessing (EMDR) therapy was performed to the patient. A thirty-four year old female married patient, had symptoms of FMS for five years. She was not on any medication. Intensity of her pain was identfied as 10 by visuel analog scale (VAS), tender point count was 15 out of 18 and the scores of Beck Depression Scale (BDS) and The Post Traumatic Diagnostic Scale (PDS) were 22 and 41, respectively. After the EMDR treatment VAS score was 3, tender point count was 11 and the scores of BDS and PDS were 2 and 6, respectively. The recovery was sustained at the 3rd and 6th months of follow up. In this case, we observed amelioration in both psychiatric and somatic symptoms of the patient after EMDR therapy and we discussed the possible mechanisms of this recovery. Searching for traumatic experiences and treating those traumas in FMS patients by EMDR or similar methods may result in favourable results. |