ISSN 1302-0099 | e-ISSN 2146-7153
TURKISH JOURNAL CLINICAL PSYCHIATRY - Turkish J Clin Psy: 9 (1)
Volume: 9  Issue: 1 - 2006
RESEARCH ARTICLE
1. Mental Competence Evaluation form (MCEF) for Assessment of Competency: Reliability, Validity and Sensitivity
Yeşim Can, Mustafa Sercan, Ömer Saatçioğlu, Hüseyin Soysal, Niyazi Uygur
Pages 5 - 16
Objectives: Determination of mental competence of the individual is needed for determination of whether persons are able to use their legal civil rights or not. It is aimed to determine the potency, reliability and validity of Mental Competence Evaluation Form (MCEF) that we have developed for evaluation of individual legal competency. Method: In order to investigate the validity and reliability of the MCEF, it was applied by two psychiatrists to 38 persons, who all were over 65 years, and who were send by notary, land office or legal judge, or were admitted by themselves to Forensic Psychiatry Unit of Bakırköy Mental Hospital in a period of three months for evaluation competency. In order to investigate the validity of MCEF, Mini-Mental State Examination (MMSE), Brief Psychiatric Rating Scale (BPRS) and Global Deterioration Scale (GDS) were also applied to all patients. Report results which were presented to the health board of our hospital and were assessed by the mentioned board, were used for comparison in the evaluation of the validityof the form. Results: Cronbach Alpha value is 0.9800, which represents the internal consistency achieved by the application of MCEF to 38 individuals. Items1 total correlations vary between 0.8712 and 0.9339. All items1 correlations are within 0.001 significance level and mean correlation is found to be 0.9009. Relationship was detected between MCEF and MMSE, BPRS and GDS. Conclusion: Our point of view is that while this form appears to be comprehensible and practicable, it may also be helpful in this area.

2. Stressful Life Events in Vitiligo and Chronic Urticaria
Meltem Sukan, Fulya Maner
Pages 17 - 26
Objective: This study was designed to investigate the quality and severity of stressful life events in two kinds of skin disorders vitiligo and chronic urticaria. Method: The study population was recruited from dermatology outpatient clinics at four major hospitals in Istanbul. 50 vitiligo, 50 chronic urticaria patients, aged 16-60 years were compared with age- and sex- matched 50 healthy controls. The sample completed the sociodemographical data form, Stressful Life Experiences Screening (SLES) and the SCID-I. Results: Among SCID-I diagnoses, only the rates of dysthymic disorder and generalized anxiety disorder (GAD) were found statistically significantly different between the two skin disorders. The rates of dysthymic disorder were 26%, GAD were 30% in chronic urticaria group in which the difference between the two skin disorders group were statistically significant in which the rates of SCID-I diagnoses were significantly higher in chronic urticaria group than in vitiligo group. Both of the patient groups experienced significantly higher rates of severe accident, injury; death of a spouse, child, close friends exposition to physical violence in childhood and adulthood, and a serious stressful event that was declared to nobody than control group. Conclusion: Our study emphasizes the importance of stressful life events leading to develop some SCID-I diagnoses in vitiligo and chronic urticaria which are skin diseases with different etiopathogenesis and clinical manifestations.

3. Bullying And Its Relationship To Symptoms Of Depression In Adolescent Students
Osman Sabuncuoğlu, Yener Akyuva, Engi Altınöz, Meral Berkem
Pages 27 - 35
Objective: Bullying, besides its negative influence on educational achievement in children and adolescents, is increasingly becoming an area of concern because of its causal relationship with psychiatric disorders. The objective of this cross-sectional descriptive study is to determine the characteristics of bullying in adolescents and investigate its relationship to symptoms of depression. Method: A total of 107 adolescents attending to a high school completed a bullying questionnaire and the Children's Depression Inventory (CDI). Results: 66.4% of the participants reported experiencing one or more types of bullying in the previous year. In these children, the CDI scores were significantly high. %43.9 of the sample reported bullying others at least at one occasion in the previous year. Of the students who were bullied, 53% reported bullying others at a statistically significant rate. The classroom was chosen to be the safest environment felt by the students. Conclusion: In the sample of adolescent students we examined, the prevalence of bullying was high and related to symptoms of depression. A continuous experience of violence and stress in social relationships may give rise to psychiatric symptoms. This study emphasizes the negative influences of peer bullying on child and adolescent mental health in our country; attracts attention to the importance of preventive and therapeutic approaches.

4. Nonmedical Help-Seeking Behaviour in Psychiatric Patients; Comparison of Turks Living in Turkey and Germany: A Preliminary Study
Hüseyin Güleç, Ayhan Yavuz, Murat Topbaş, İsmail Ak, Elif Kaygusuz
Pages 36 - 44
Amaç: Bu çalışmada ülkemizde (Trabzon'da) ve iş bulma nedeniyle yurtdışında (Almanya- Gelsenkirchen) yaşayan ve psikiyatrik bir hastalığı olan Türklerin gösterdikleri tıp dışı tedavi arama davranışı ve buna eşlik eden faktörlerin incelenmesi amaçlanmıştır.Yöntem: Bu çalışma Eylül 2002- Şubat 2003 tarihleri arasında, Trabzon'daki ve Gelsenkirchen'deki iki psikiyatri polikliniğine başvuran hastalara anket verilerek yapılmıştır. Ankette yaş, cinsiyet, medeni durumu, yetiştirildiği yer, din eğitimi alma durumu, tıp dışı başvurusunun olup olmadığı, varsa bunların ne olduğu ve verilen önerilere uyma davranışı sorulmuştur. Veriler student-t testi ve ki-kare testi ile karşılaştırılmıştır. Bulgular: Türkiye'dekilerin %49.4'ü, Almanya'dakilerin ise %55.0'ı psikiyatrik hastalıkları için tıp dışı tedavi arama davranışı gösterdikleri bulunmuştur. Erkeklerde iki grup arasında istatistiksel olarak anlamlı fark olmamakla birlikte; Almanya'da yaşayan kadınların (%65.5), Türkiye'dekilerden (%41.8) daha fazla tıp dışı tedavi arama davranışı içinde oldukları bulunmuştur (p=0.039). En fazla rastlanan tıp dışı tedavi arama davranışı olarak din hocasına gitme (Türkiye'dekiler %74.4, Almanya'dakiler %87.9) bulunmuştur. Türkiye'de- kilerin %20.9'unun, Almanya'dakilerin ise %9.1'inin verilen önerilere uydukları saptanmıştır. Sonuç: Her iki grupta da psikiyatrik hastalığı olanların yaklaşık yarısının tıp dışı tedavi arama davranışı içinde oldukları saptanmıştır. Bu nedenle tıp dışı tedavi arama davranışına etki eden faktörleri ve bunun sonuçlarını daha iyi ortaya koyabilmek için daha kapsamlı çalışmalara gereksinim vardır. Anahtar Sözcükler: Tıp dışı başvuru, çare arama, Türkler.

CASE REPORT
5. Delusional Misidentification: Presentation of a Case of Capgras Syndrome
Eylem Özten, Ali Evren Tufan, İrem Yaluğ, Cem Cerit, Sibel Işık
Pages 45 - 48
Capgras syndrome is placed among the group of delusional misidentification syndromes and is characterized by delusions which are rare and resistant to treatment. The patient believes one of his close relatives, and even himself to be changed with a doppelganger. It is commonly accompanied by schizophrenia or organic psychosis and is very rare in its pure form. The psychosis is of the paranoid type in most of the cases. It is also known to accompany mania and psychotic depression. The etiology of this rare psychiatric syndrome remains elusive. Most of the cases are explained with psychoanalytic terms, although in later cases diffuse or localized brain lesions are suspected to be responsible. Some authors posited that organic and psychodynamic causes may coexist. In this study, a case of Capgras syndrome, in which psychodynamic causes are thought to be more prominent, is presented. Because of the facts that our patient believed his parents to be changed with their doppelganger, this delusion was more prominent than delusions of persecution, being both progressive and resistant and the presence of auditory hallucinations; Capgras syndrome with Schizophreniform disorder was diagnosed. Although, psychodynamic explanations of this phenomenon may be possible, a detailed neuropsychiatric evaluation was deemed necessary to rule out an organic cause.

6. Male Pseudohermaphroditism: A Case Report
Asena Akdemir, Olga Güriz, Sibel Örsel, Akfer Karaoğlan
Pages 49 - 52
Various theories that range from innate characteristics to environmental contributions exist as regarding factors affecting the development of sexual identity. Normal sexual differentiation which evolves under the influence of systemic or localized hormones in addition to chromosomal order may be broken down with genetic abnormalities, hormone secretion deficiencies and lack of response in target organs. Despite noticing and evaluation of patients with ambiguous genitalia in early period of life especially in the newborn period is important for the prevention of possible further emotional or organic deficiencies, there are still cases remained unnoticed until the adolescence or adulthood period in our country. In this case report, a 24 years old male patient with diagnosis of male pseudohermaphroditism is presented. He had been seen for preoperational psychiatric consultation upon decision of the ethical committee after being hospitalized for penis reconstruction operation and reevaluated after psychological counseling process and the decision for surgery and following post-surgical psychological counseling process was taken. The patient had gone through penis reconstruction beside left orchiectomy operation that had been performed to prevent cancer risk. After the operation he continued his life as a male. Our knowledge on normal psychosexual identity development and the factors it has been affected from is increasing with studies being conducted but still limited. In this case report, despite being raised completely as a girl the patient chose his sexual identity on the base of innate characteristics. This shows us the importance of organic factors in the selection of sexual identity.

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