Genetik etldnin affektif bozukluklarm etiyolojisindeki rolii He Hgi- li ilk bulgular, aile, ikiz ve evlatlik gahgmalari He ortaya konmug, daha sonra geligtirilen genetik gahgma yontemleri He genetik et- ki aragtmlmigtir. Boylece psikiyatrik genetik konusunda ‘antisi- pasyon’ (sonraki nesillerde hastabk beklentisinde artma) ve ‘kay- nak ebeveyn etkisi’ gibi yeni sayilabilecek kavramlar bulunmug- tur. Hasta bireylerde kontrollere gore daha fazla genig trinukle- otid tekrariannm saptanmasi, bipolar affektif bozuklugun etiyo- lojisinde bunun rol oynayabilecegini ve buyiik olasilikla da anti- sipasyondan sorumlu olabilecegini gostermektedir. Etkilenmig annelerden gelen neslin, etkilenmig babalardan gelen nesile gore belirgin olarak daha fazla hastalanma riskinin oldugu gosteril- mig ve bu durum kaynak ebeveyn etkisi olarak adlandirilmigtir. Kromozomal lokalizasyonu belirlemek fin baglanti analizleri kullamlmig, bu gekilde birgok kromozom iizerinde baglanti oldugu gosterilmig, fakat sadece 18. kromozomun ilgili lokusu He ilig- kili baglanti diger gahgmalarla da dogrulanmigtir. Diger kromozomal lokalizasyonlarla ilgili baglantilar farkli gahgmalarla dog- rulanamasa da yanhghgi da gosterilememigtir. Affektif hastahk- larm kompleks kalitimla gegen genetik bir hastalik oldugu dilgu- nulurse, eldeld tekniklerle heterojen hasta gruplarmda tek ve or- tak bir kromozomal lokus gosterebilmenin zorlugu anlagilabilir. Bu sebeple bir ailede belli bir kromozomal lokusta baglanti sap- tanabilirken diger ailelerde gosterilemeyebilir. Daha genf ve ho- mojen aile ve hasta gruplarimn olufurulmasiyla bu smirlama a$Aabilir. Eldeki bilgiler affektif bozukluklarda genetik etldnin onemli oldugunu gostermekte ve ilerild galigmalar igin cesaret vermektedir.

First evidences on the role of genetic effect in the etiology of affective disorders were put forward by the family, twin and adoption studies and then effects of genetic have been researched by the means of advanced genetic studies. These researches lead to the development of recent concepts in psychiatric genetics like ‘anticipation’ (increase in disease severity and / or decrease in age of onset in successive generations) and ‘parent of origin effect’. Identification of large intervals oftrinucleotid repeats in affected individuals when compared with control subjects, implicated the role of trinucleotid repeats in the etiology of bipolar disorder which at the same time seems to be the cause of anticipation. It has been shown that morbidity risk is significantly higher in off springs of affected mothers when compared with offsprings of affected fathers which is defined as ‘parent of origin effect’. Linkage analysis has been used to define the chromosomal locations, linkage has been reported on many chromosomes but only the linkage on chromosome 18 has been replicated by other genetic studies. Although the linkages on other chromosomes were not replicated by other studies, they were not denied otherwise. If the bipolar disorder is accepted as a disorder of a complex inheritance, difficulty to find only one or shared chromozomal loci in heterogen samples could be understood. Therfore one chromozomal linkage in one family could not be proven in other families. This limitation could be passed by larger and more homogeneous sample size. Informations in hand indicate that genetic effect is important for affective disorders and encourage for further studies.

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Dissosiyatif kimlik bozuklugu dissosiyatif bozukluklarm en agir ve kronik olamdir. Bir zamanlar samldigmm aksine, DSM-IV tarn olgutlerini tam olarak dolduran bigimi en az fizofreni kadar sik gbriilen dissosiyatif kimlik bozuklugu son yillarda iilkemizde genig aragtirmalara konu olmugtur. Ruhsal travma He yakm ilig- kisi olan ve etiyoloji ve tamyi dikkate alan bir psikoterapi gerek- tiren bu bozuklukta agiri ve anlamsiz olgilde deskriptif egtamya rastlanmaktadir. Bu durum dissosiyatif kimlik bozuklugunun hi- yerargik yaklagimla iisttam sayilmasmi gerektirmekte ve smiflan- dirma sistemlerinde onemli degigiklikler yapdmasi geregine iga- ret etmektedir. Dissosiyatif kimlik bozuklugu giiniimiizde gegerli psikiyatrik smiflandirma ve nozolojinin onemli eksikliklerine dik- kat gekmektedir.

Dissociative identity disorder is the most severe and chronic form of dissociative disorders. In contrast of imagined previously, its complete form defined in the DSM-IV is at least as frequent as schizophrenic disorder in the community. Recently, extensive research and clinical work has been conducted on dissociative identity disorder in Turkey. This trauma related disorder requires specific psychotherapeutic intervention considering the diagnosis and etiology; however, it is not uncommon for these patients to fit diagnostic criteria of several other psychiatric disorders at the same time. This excessive descriptive comorbidity can be solved accepting dissociative identity disorder as a supraordinate diagnosis of traumatic origin. This solution needs extensive revision in classification systems currently in use. Dissociative identity disorder challenges the current psychiatric classification and nosology.

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fekingen Kigilik bozuklugu (fKB) konusunda gimdiye dek az sa- yida galigma yaymlanmigtir. fKB'nun, sosyalfobi (SF) ve bazi ki- §Hik bozukluklariyla ortak ozellikleri vardir. CKB'nun tedavisi konusunda yeterli bilgi birikimi olmamasi ve diger bozukluklarla arasmdaki bu ortiigme nedeniyle (iKB'nun tedavi stratejisi daha gok, SF gibi ortak dzellikler tagidigi diger bozukluklarm tedavi- leriyle belirlenmiftir Bu yazida QKB'nun klinik ozellikleri ve tarn- sal sorunlari hakkmda bilgi sunulmuytur. Bunun yam sira dzellik- le SF He ilifkisi gdz online almarak QKB'ndaki farkh tedavi yak- lafimlari tartiglrngtir.

The research literature on avoidant personality disorder (APD) is quite sparse. APD shares many elements with the Axis I disorder social phobia (SF) as well as with the other personality disorders. Because of this overlap and the lack of extensive literature on the effective treatment of avoidant personality disorder, treatment strategy of APD is determined mostly by the known effective treatments of disorders with which avoidant personality disorder shares common elements, especially SF. In this article we presented clinical features and the diagnostic matters of APD. We also discussed the different treatment approaches in respect to its relationship especially with social phobia.

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Bu aragtirmada ikiuglu duygudurum bozuklugu hastalanyla ruh- sal hastahk oykiisu bulunmayan saglikh kontrol grubu arasmda HLA antijenlerinin sikligi kargilagtirilmigtir. Iki uglu duygudurum bozuklugu tamsi DSM-III-R olgiitlerine gore konmugtur. 50 ikiug- lu duygudurum bozuklugu hastasi He 100 kigi kontrol grubunda HLA A, B, C, DR ve DQ antijenlerinin sikligi kargilagtirilmigtir. HLA B7, DR11 ve DQ 7 antijenlerine ikiuglu duygudurum bozuklugu grubunda daha sik rastlanmigtir. Bu sonuglar en azmdan bazi HLA antijenlerinin duygudurum bozukluklariyla iligkili ola- bilecegini dugundurmektedir.

This study compared the frequencies of HLA antigens of subjects with bipolar disorder to subjects with no history of any mental illness. Diagnoses were rendered according to DSM-III-R criteria. A total of 50 bipolar I subjects were compared to 100 never-ill subjects on HLA loci A, B, C, DR, DQ. In bipolar I patients, antigens of HLA B7, DR 11 and DQ7 were more frequent than control group. These findings indicate that at least some HLA antigens might be related to bipolar disorder.

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Bu kisa gozden gegirmede belki de psikiyatri tarihinin en hizh ge- ligen alanlarmdan bin olan gizofreni norobiyolojisi hakkmda bir izlenim sunulmaya galigilmigtir. gizofreni kliniginin ortaya giki- gmda rol alan temporal loblar ve prefrontal korteks He ilgili ana- tomik bulgular kisaca ozetlenmig, ardmdan gizofrenide noro- transmiter sistemleri He ilgili bulgulardan dopamin, serotonin ve glutamat iizerinde durularak soz edilmigtir. Bugiin bildiklerimiz biraraya getirildiginde gizofreni patojizyolojisinin anlagilmasin- da uzun, ama umut verici bir yolun baginda oldugumuz gortil- mektedir.

The aim of this short overview is to give a perspective on one of the fastest developing fields of psychiatric history, neurobiology of schizophrenia. A short summary of anatomical findings on prefrontal korteks and temporal lobes in schizophrenia is followed by the findings on neurotransmitter systems, dopamine, serotonin and glutamate in particular. When those findings are put together, it seems that we are at the beginning of a long but hopeful quest for understanding pathophysiology of schizophrenia.

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Çalýþmamýzda, Elazýð ve Paris gibi; psikososyal ve kültürel koþullarýn çeþitli yönlerden birbirine zýt olduðu ortamlarda obsesif kompulsif bozukluk tanýsý alan hastalarýn; sosyodemografik, klinik ve görüngüsel özelliklerinin karþýlaþtýrýlarak kültüre özgü farklýlýklarýnýn irdelenmesi amaçlanmýþtýr. Çalýþmaya, Fýrat Üniversitesi Týp Fakültesi
ve Paris Hospitalo-Universitaire de Sainte-Anne psikiyatri kliniklerine ilk kez baþvuran, DSM-IV taný ölçütlerine göre OKB tanýsý konulan 30’ar, toplam 60 hasta alýndý. Hastalara DSM-IV taný kriterlerine göre OKB dýþýndaki 1. Eksen tanýlarý belirlenerek sosyodemografik ve klinik özelliklerini irdelemeyi amaçlayan bir form uygulandý. Fransýz hastalarýn öðrenim düzeyi Türk hastalardan anlamlý þekilde yüksekti. Mesleki yönden Türk hastalarda ev kadýný ve memur olanlar, Fransýz hastalarda iþçi ve serbest çalýþanlar çoðunlukta idi. Türk hastalarda evli, Fransýz hastalarda bekar olanlar çoðunluktaydý. Türk hastalarda OKB’a depresif bozukluklar, Fransýz hastalarda alkol kötüye kullanýmý istatistiksel farklýlýk oluþturacak þekilde eþlik etmekteydi. Kirlilik, kir ve pislik bulaþmasý konulu obsesyonlar ve temizlik-yýkama kompulsiyonlarý her iki hasta grubunda da en sýk tanýmlanan obsesyon ve kompulsiyonlardý. Türk kadýn hastalarda; kir-pislik bulaþmasý obsesyonlarý ve temizlik yýkama kompulsiyonlarý, erkek hastalarda dinsel obsesyonlar ve dua kompulsiyonlarý, Fransýz erkek hastalarda zarar verme obsesyonlarý istatistiksel açýdan anlamlý olarak yüksek bulundu.

The aim of our study was to compare sociodemographic, clinical and phenomenological characteristics and to determine cross cultural differences in patients diagnosed as obsessive compulsive disorder (OCD) in Elazýð and Paris which have opposite features
about psyhosocial and cultural characteristics. The study group included totally 60 patients who had applied to Psychiatry Department of Medicine Faculty of Fýrat University and Psychiatry Department of Paris Hospitalo Universitaire de Sainte-Anne firstly, and diagnosed OCD according to DSM-IV criteria. According to DSM-IV diagnostic criteria, axis I diagnosis other than OCD was determined and a form evaluating sociodemographic and clinical properties was applied to patients. The education level
was significantly higher in French patients than Turkish patients. In regard to occupation, housewifes and officials in Turkish patients, workers and free workers in French patients were obvious. Turkish patients were usually married, contrary French patients were single. Depressive disorders in Turkish patients and learned alcohol abuse in French patient were statistically significant comorbid diagnosis. Dirty, dirt and contamination obsessions and cleaning-washing compulsions were most prevalent obsessions and compulsions in both groups. In Turkish female patiens dirt and contamination obsessions and cleaning-washing compulsions, in Turkish male patiens religious obsessions and praying compulsions, in French male patients harming obsessions were found statistically significant.

Sirtir sistemi gdruntiilenmesi He ilgili teknikler radyasyonla karp- lagmayi gerektirdiginden arapirmalarda denek guvenligi sorunu olufrurmufiardir. Bu nedenle gocuk ve ergenlerin noropsikiyatrik bozukluklannda erifidnlere layasla smirh sayida gahgmada kulla- mlmifiardir. Magnetik rezonans goruntulemesi gibi bazi yontem- lerde guvenligin saglanmasi He artik gocuklarda da beyin yapisi ve iglevleri daha fazla galiplabilmektedir. Bu yazida gocukluk ve ergenlik doneminde bafiayan noropsikiyatrik bozukluklar konu- sunda sinir sistemi goruntuleme teknikleri He elde edilen bilgiler aktarilacaktir. Disleksi, zeka geriligine neden olan bazi hastalik- lar ffrajil X sendromu, Down sendromu), Rett sendromu, otizm, obsesif-kompulsif bozukluk, dikkat eksikligi hiperaktivite bozuk- lugu, Tourette sendromu ve pzofreni konusundald goruntuleme teknikleri He elde edilen arafiirma sonuglari dzetlenecektir.

Techniques related to imaging of the nervous system, due to their necessity of exposure to radiation, leads to problems of subject safety in studies. Therefore neuroimaging was used in limited number of studies in neuropsychiatric disorders of children and adolescents when compared with adults. By the means of safer procedures like magnetic resonance imaging, studies related to brain function and structure are increased in number. In this paper neuroimaging finding in neuropsychiatric disorders of child and adolescents will be reviewed. Results of neuroimaging studies on dyslexia, some disorders which yield to mental retardation (fragile X, Down syndrome), Rett syndrome, autism, obsessive- compulsive disorder, attention deficit hyperactivity disorder, Tourette syndrome and schizophrenia will be summarized.

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Gilnumuzde psikoterapi alanmda farkh kuramlar ve uygulama- lar kullamlabilmektedir. Bir terapi sirred tek bir kurama bagh olarak surduriilebilecegi gibi eklektik bir yakla§im da terdh edi- lebilmekte ve kuramsal olarak degifik agdardan ele almabilmek- tedir. Ergen terapisinde de olgunun klinik tablosu ve terapi sürede farklý temellere dayandmlabilmektedir. Buyazida Gazi Univer- sitesi Tip Fakültesi (çocuk Psikiyatrisi boliimunde yaklaþik 2 yil psikoterapisi yiirutulmu$ bir olgunun klinik tablosu ve terapi sirred aktarilacaktir. Olgu kendilik psikolojisi kurami apsmdan tar- tiplacaktir.

Nowadays different theories and practices could be used in psychotheurapeutic approach. Although one therapy course could be performed according to only one theory, ecletic techniques could also be prefered. In adolescent therapy clinical features and therapy could be based on different theories. This paper is related to clinical aspect and therapy course of an adolescent case whose psychotherapy was performed for 2 years in Gazi University Faculty of Medicine Child Psychiatry department. This case will be discussed according to theory of self psychology.

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