ISSN 1302-0099 | e-ISSN 2146-7153
TURKISH JOURNAL CLINICAL PSYCHIATRY - Turkish J Clin Psy: 7 (3)
Volume: 7  Issue: 3 - 2004
RESEARCH ARTICLE
1. Predicting Level of Attention Deficit Hyperactivity Disorder (ADHD) from Tests of Intelligence and Other Related Neuropsychological Devices
Nurcihan Kiriş, Sirel Karakaş
Pages 139 - 152
Objectives: Raven Standard Progressive Matrices (RSPM) assess visuo-spatial perception, reasoning, intellectual flexibility, abstract reasoning and analytical thinking, thus 'fluid' intelligence. Wechsler Intelligence Scale for Children-Revised (WISC-R) is a general ability test that is highly loaded with academic achievement. In this study, the applicability of RSPM in the evaluation of Attention Deficit Hyperactivity Disorder (ADHD) was studied. Besides RSPM, the study utilized Bender Gestalt Test (BG) which measure visual perception; Conners Parent Rating Scale (CPRS) and Conners Teacher Rating Scale (CTRS) which are used in rating ADHD. The processes that RSPM along with the other tests measure were investigated through factor analysis. The correlations between RSPM and the other tests and predictability of CPRS and CTRS from test scores were investigated. Materials and Method: The sample consisted of 45 males who were in the age range of 6-11 years and who were not yet on pharmacotherapy. Results: Pearson Correlation Analysis revealed significant correlations between scores of RSPM and WISC-R; between CTRS score and subtest scores of WISC-R; between RSPM and BG scores and subtest scores of WISC-R. Stepwise multiple regression analysis revealed that CTRS could be predicted from Similarities score of WISC-R and BG score with an explained variance of 20%. The addition of RSPM to the predictor variables increased the explained variance to 40%. Conclusion: This study showed that the type of abilities that RSPM measure contributes to predicting ADHD. Thus, it would be useful to add RSPM to the tests that are used in the diagnostic assessment of ADHD.

2. The Effects of Somatic Symptoms on Suicidal Ideation, Behaviour and Intent in the Patients with Major Depression
Ozan Pazvantoğlu, Tuncer Okay, Nesrin Dilbaz, Cem Şengül, Göksel Bayram
Pages 153 - 160
Objective: Major depressive disorder is a common psychiatric disorder which can cause suicide. Somatic symptoms may be seen in many psychiatric disorders depending on culture and socioeconomic status of the country. This study aimed to determine the severity of somatic symptoms and their association with suicide risk in patients who had been diagnosed as major depressive disorder. Method: The study involved 30 patients who were admitted to mood disorder outpatient unit of our clinic and diagnosed as major depressive disorder based on DSM-IV criteria. The patients were psychotrophic- medication naive for the one last month. They enrolled into the study with their consent. The patients were assessed with Hamilton Depression Scale, scale of suicidal ideation, suicide intention scale and suicidal behaviour scale. The patients were divided into two groups according to Hamilton Depression scale scores to evaluate severity of somatic symptoms. The groups were compared for suicidal ideation, suicidal intention and suicidal behaviour mean scores. Result: The patients with more severe somatic symptoms had significantly higher scores (p=0.05) in suicidal behaviour scales compared to the other patients with less severe somatic symptoms. There were no significant differance between the groups according to suicide idention scale (p=0.5). The patients who attempted suicide assessed with suicidal intension scales. Conclusion: The results are suggestive of a strong association between somatic symptoms and suicidal behaviour. The results also indicate that in patients applying with physical complaints to the departments other than psychiatry clinics should be well-evaluated for suicidal risks.

REVIEW
3. Unipolar Mania
Fatih Volkan Yüksel, Aydın Kurt, Verda Tüzer, Erol Göka
Pages 161 - 166
DSM-IV and ICD-10 suggest that the patient experiencing only one manic episode or recurrent manic episodes without any depressive episodes should be diagnosed as bipolar disorder. However, there are studies suggesting that the patients experiencing recurrent manic episodes should be characterized as unipolar mania and this diagnosis should be recorded in the international psychiatric nosology. In order to develop such a concept, it is essential to know the prevalence of unipolar mania, whether there are differences between unipolar mania and manic episode of bipolar disorder and one should be aware how the previous and future depressive episode could be eliminated. Some studies in the literature suggest that unipolar mania is rarely observed and has no significant difference from the manic episode of the bipolar disorder. Conversely, some recent studies claim that the unipolar mania is not rarely seen and differs from mania in the bipolar disorder in terms of clinical, socio-demo- graphic factors and response to the treatment. This article focuses on the frequency of unipolar mania through exploring the prevalence rates in different cultures, the differences that discriminate unipolar mania from the manic episode of the bipolar disorder and the ways to eliminate possible depressive episodes through reviewing the literature.

CASE REPORT
4. When is Traumatic Grief Diagnosed? When Should the Treatment Begin?
Ufuk Sezgin, Şahika Yüksel, Zerrin Topçu, Aysun Genç Dişcigil
Pages 167 - 175
The objective of this case study is to investigate the outpatient population of a psychiatric clinic who have applied because of different psychological problems following a sudden and traumatic death of a first degree relative. This study considers causes of death, application complaints, diagnosis, treatments and follow-up. Demographic characteristics, causes of death, psychological problems arising following the loss and the diagnoses were assessed, during the clinical interviews with the applicants. In this assessment, The Impact of Event Scale - Revised and The Post-Traumatic Stress Diagnostic Scale (PDS), which are self- rated, have been used. This case study included 14 female and 2 male outpatients. The mean age of the applicants was 34.31 ±12 (17-57) and the duration between losses and applications to seek help ranged from 1 to 36 months. The reported losses were traumatic and sudden deaths. The most frequent diagnosies were Traumatic Grief (n=14), Post Traumatic Stress Disorder (n = 10) and Major Depressive Disorder (n=8). In order to choose the treatment approach, the problem needs to be identified first. There are risks for development of different psychological disorders following losses. Several psychological disorders such as Traumatic Grief, Post Traumatic Stress Disorder, Major Depressive Disorder, Panic Disorder and Generalised Anxiety Disorder may develop following significant loss. These problems may arise immediately following the loss as well as after some delay. The grief due to the loss is a normal and natural reaction. The disturbance of this natural course due to sudden and terrific loss may cause traumatic grief. This traumatic impact is a risk for development of physical and psychological disorders. This study indicates the possible need for support following traumatic and sudden losses.

RESEARCH ARTICLE
5. Tianeptine Induced Mania: A Case Report
Sema Gülen Yıldırım, Ayşe Devrim Başterzi, Erol Göka
Pages 177 - 180
For a long time tricyclic antidepressant drugs, monoamine oxidase inhibitors, selective serotonin reuptake inhibitors and moreover bupropion usage is known to be able to cause mania or hypomania. Occurrence of mania or hypomania is less probable with serotonin re-uptake inhibitors when compared with tricyclic antidepressants, Antidepressant treatments is known to be able to cause manic shift for a long time. But it must be argued that whether this manic shift depends on doses or not. The mania state that occures after antidepressant usage is shorter and softer than spontanous mania and less delusion, hallucination, ajita- tion and bizarre behaviours are observed. About %15-25 of the patients with bipolar disorder who treated with antidepressants may show tendency to mania. 1/3 of the distimic patients and %10-30 of those who have social phobia, obsesive-compulsive disorder and panic disorder could have hipomania. In this report, a patient is presented who has hypomania that is developed after tianeptine usage owing to generalized anxiety disorder. Any case presentation relating to a new antidepressant tianeptine usage that cause mania situations is not found in the literature. The similarity of the chemical structure of tianeptine with tricyclic antidepressants is thought to be able to cause hypomania.

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