ISSN 1302-0099 | e-ISSN 2146-7153
TURKISH JOURNAL CLINICAL PSYCHIATRY - Turkish J Clin Psy: 2 (1)
Volume: 2  Issue: 1 - 1999
REVIEW
1. Psychotherapies in Transcultural Perspective
Cengiz Güleç
Pages 5 - 11
Contemporary American standards for clinical competence requires a biopsychosocial approach to patient care. Meaning of this standarts is the combined use of supportive-expressive cognitive psychotherapy and disorder-specific medication together in standard psychiatric practice. This paper focuses on the cross-cultural aspects of models of patient care. Common factors affecting a positive outcome in most patients from various ethnic backgrounds are discussed. This paper argues that supportive- expressive psychotherapy which conforms to specific established rules is more ethical, effective and efficient than non-standard- ized, culture-specific therapies.

2. Emotional Intelligence
Ceylan TUĞRUL
Pages 12 - 20
Recent studies revealed that the definition of "intelligence" should be expanded and in addition to classically accepted IQ (entellec- tual intelligence), EQ (emotional intelligence) should also be included in this definition. Emotional intelligence consists of the abilities like knowing own emotions, managing emotions, motivating oneself, being empathic and handling relationships. Age, family environment and gender are the most important factors that effects the development of emotional intelligence. The problems that arise during the development of emotional intelligence play an important role in the occurance of both interpersonal relation problems and psychological disturbances.

RESEARCH ARTICLE
3. Changes in Lipid Metabolism in Generalized Anxiety Disorder
Levent SEVNÇOK, Aslıhan Büyüköztürk
Pages 21 - 25
High cholesterol levels are among the important risk factors for coronary heart disease. To date, there have been a few of studies which examine the relationship between generalized anxiety disorder (GAD) and blood lipid levels. In the present study, we exam-ined blood levels of cholesterol, triglyceride, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) in 27 patients with GAD in comparison to 24 control subjects. We also investigated the relationships among the duration of illness, the severity of anxiety and lipid levels. Our results indicate that the cholesterol and triglyceride levels in GAD group are significantly higher than control group. We found no significant relationships among the duration of illness, the severity of anxiety and lipid levels. Our findings suggest that increased noradrenergic activity may be responsible for the elevations in cholesterol and triglyceride levels in patients with GAD.

4. Clinical Features in Trichotillomania
Vehbi Keser, Raşit TUKEL, Nuray KARALI, Celal ÇALIKUŞU, Tuba ÖZPULAT Olgun
Pages 26 - 33
In this study, we investigated the demographic and phenomenological features, comorbidity, and family history in a series of 19patients with trichotillomania. The patiens were assessed with a semistructured interview that focused on the demographic characteristics and hair-pulling behaviour, the Structured Clinical Interview for DSM-III-R, the Manual for the Structured Clinical Interview for DSM-III-R Personality Disorders. Eighty-four percent of the patients were female. The mean age at onset of hair pulling was 15.4 years, the mean duration was 11 years. Seventy-nine percent of the subjects reported pulling out hair primarily from the scalp. All subjects described a sense of relief, 14 (74%) gratification after pulling out their hair. Twenty-one percent of the patients had an associated diagnosis of obsessive compulsive disorder; 21% dysthymia; 10.5% generalized anxiety disorder; 5.3% current major depressive episode; 15.8% past major depressive episode. Personality disorders were present in 36.8% of the patients. We have discussed our findings in the light of the literature.

REVIEW
5. Posttraumatic Stress Disorder
Fuat Özgen, Hamdullah AYDIN
Pages 34 - 41
Posttraumatic Stress Disorder (PTSD) is a psychiatric disorder with specific symptoms that include being lived the witnessing or confronting traumatic events recurrently, avoiding the remem- berances and startling. Psychological factors, HPA axis and sero- toninergic systems disfunctions and adrenergic hyperactivity play an important roles in the etiology of PTSD. However, there are decreased plasma and urine cortisol levels, low frequency DST pozitivity and increased glicocorticoid receptors. In this article, symptoms, etiology and diagnosis of the PTSD was discussed in the light of literature.

6. Art, Self-Object and Inspiration
Melike Güney
Pages 42 - 45
This paper discusses how the art object can junction as a selfobject for the artist and comments on the transformation of the artist's inspirational experiences to the work of art with the contribution of aesthetic elements.

7. Self-injurious Behavior (Self-Mutilation)
Saynur CANAT
Pages 46 - 48
Self-injurious behavior (self-mutilation, self-harm) has been described as a complex group of behavior resulting in deliberate destruction of body tissue without conscious suicidal intent. Deliberate, nonsuicidal destruction of one's own body tissue, occurs in such culturally sanctioned practices as tattooing, body piercing and healing, spiritual and order preserving rituals. As a symptom self-injurious behavior is common among people with severe mental retardation, borderline and other personality dis-orders, eating disorders and factitious disorder. The purpose of this paper is to review etiology, clinical features and therapy of the self injurious behavior.

8. Transsexualism: Related Concepts and Sex Reassignment Interventions
Mehmet SUNGUR, Özlem YALNIZ
Pages 49 - 54
Despite the fact that transsexualism is a gender identity disorder which is probably as old as the history of mankind, it is recognized as a phenomenon only in the last four decades. In this context: Is transsexualism a phenomenon of the XX th century or is it just that in this era personal differences on sexual attitudes are more tolerated, and therefore more readily declared? This paper aims to review the assessment, diagnostic criteria, incidence, prevalence, sex ratio and etiology of transsexualism which may help to answer the question above. The concept of primary transsexualism is reviewed and the outcomes of sex reassignment surgery as well as those cases which are better candidates of a successfulI intervention are discussed.

RESEARCH ARTICLE
9. The Characteristics of the Institutions which Give Psychiatric Education and Services in Pre-and/or Post- Graduate in Turkey
Orhan Doğan
Pages 55 - 61
In this study, it has been investigated that the characteristics of twenty-eight instituions which give psychiatric education and psychiatric services in pre-and/or post-graduate. The data have been collected by a questionnaire form. The characteristics of twenty-eight institutions have been assessed according to the kind of institutions and where they are placed. It has been found that the number of education members is not enough in universities and the service responsibility is too much in the other institutions. In order to increase the quality of education and services, some suggestions have been proposed.

CASE REPORT
10. Panic Disorder and Psychological Defence Processes of a Quadriplegic Patient
Oya AYDINER, Işın BARAL KULAKSIZOĞLU
Pages 62 - 66
The spinal cord injuries cause important social, psychological and physical problems in daily life of the patients. Due to spinal cord injuries secondary psychiatric disorders occur related to physical illness such as depression, panic disorders, posttraumat- ic stress disorders, adjustment disorders (with depression and/or anxiety), acute stress reactions and other anxiety disorders. In the process of adaptation to the new situation, patient develops some ways to cope. Spinal cord injured patients generally use denial, minimization and rationalization. Early coping mechanisms may facilitate treatment and the adaption to the new situation in the early stages on the contrary may became maladaptive in the later stages. In this paper a young man who use especially denial as a defense mechanism, who has difficulties about acceptance of his physical status and who has been diagnosed as a panic disorder after the development of quadriplegia is presented. The aim of this paper is to emphasize the necessity of multidiciplinary, biopsychosocial treatment approach to the patient with physical illness.

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